HomeMy WebLinkAbout231300 04/08/14 (9)
CITY OF CARMEL, INDIANA VENDOR: 179340
ONE CIVIC SQUARE LAERDAL MEDICAL CORP CHECK AMOUNT: $*****5,000.00*
CARMEL, INDIANA 46032 P 0 BOX 8500-53168 CHECK NUMBER: 231300
PHILADELPHIA PA 19178-3168 CHECK DATE: 04/08/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4467099 1-lI9UA3 5,000.00 OTHER EQUIPMENT
- 'Laerdal'"
helping save lives Invoice
Laerdal Medical Corporation Date: 03/11/14
167 Myers Corners Road Quote#: 1-119UA3
Wappingers Falls, NY 12590 Acct#: 00119576
Terms: Net 30 Days
Ph: 800-431-1055 Shipped: FedEx Ground
Fax: 800-227-1143 FOB: Ship Point
Bill To Ship To
Carmel Fire Department Carmel Fire Department
2 Civic Square 2 Civic Square
Carmel, IN 46032 Carmel, IN 46032
Attn: Division Chief Tom Small
Item Part# Description Unit Quantity Unit Price Amount
1 205-05050DEMo ALS Simulator Manikin Demo Unit Pt 1 EA 1 5000.00 $5,000.00
Part 1 Serial # 205MO5080026
Total Amount $5,000.00
Tax
Shipping
Total Invoice $5,000.00
Payment
Balance Due $5,000.00
Message
r
mit to: Laerdal Medical Corporation
Attn: Patti Axelby
167 Myers Corners Rd.
Wappingers Falls, NY 12590
Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1-119ua3 $5,000.00
I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Laerdal Medical Corporation
IN SUM OF $
167 Mef-&-Corners Rd
Wappingers Falls, NY 12590
$5,000.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I 1-119ua3 1102-670.99 I $5,000.00 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except A 9
� .a 920 114
d.
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund