HomeMy WebLinkAbout32484 MEDTECH ForensicsCi
of Carmel
ONE CIVIC SQUARE
CARMEL, INDIANA 46032 -2584
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
FEDERAL EXCISE TAX EXEMPT
35- 60000972
PAGE
PURCHASE ORDER NUMBER
32484
THIS NUMBER MUST APPEAR ON INVOICES. NP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
'PURCHASE ORDER DATE
DATE REQUIRED
REQUISITION NO.
VENDOR NO.
DESCRIPTION
10114/2014
MEDTECH Forensics, Inc
VENDOR
4389 Huggins Hill Lane
Tallahassee, FL 32311 4)731
SHIP
TO
Cannel Police Department
3 Civic Square
Cannel, IN 48032
(317) 571-2559
CONFIRMATION
BLANKET
*CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY
UNIT OF MEASURE
DESCRIPTION
UNIT PRICE
EXTENSION
Account 420,99
1 Each RTX, 80m1
2 Each Sterile Water Capsules, 3m1 100/box
1 Each face mask, N95 NIOSH partial mask
1 Each 'RAY' mixture, premixed 1 litre
Quote 04033
Send Invoice To:
Cannel Police Department
Attn: Pat Young
3 Civic Square
Cannel, IN 48032-
3152
HUD20031Z
ALP -895
PLEASE INVOICE IN DUPLICATE
$58.00
$22.00
$144.00
$28.95
Sub Total:
$58.00
$44.00
$144.00
$28.95
$274.95
DEPARTMENT
ACCOUNT
PROJECT
PROJECT ACCOUNT
Carmel Police Dept.
SHIPPING INSTRUCTIONS
• SHIP REPAID.
• COD. SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 32484
ORDERED BY
TITLE
•
CLERK-TREASURER
OFFICE COPY
PAYMENT
• NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
I HEREBY CERTIFY THAT T» RE IS AN UNOBLIGATED BALANCE IN
THIS APPROP FICIENT TO PAY FOR THE ABOVE ORDER.
AMOUNT
$274.95