246196 06/17/15 CITY OF CARMEL, INDIANA VENDOR: 369478CHECK AMOUNT: $*******159.82*
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ONE CIVIC SQUARE ARROW INTERNATIONALCARMEL, INDIANA 46032 3015 CARRINGTON MILL BLVD CHECK NUMBER: 246196
MORRISVILLE NC 27560 CHECK DATE: 06/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 93109017 159.82 SPECIAL DEPT SUPPLIES
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93109017 05/28/2015 1 of 1 06/27/2015
Payer Account No. 1057230
Bill To Party Account No. 1057230 Ship To Party Account No. 1057230
Carmel Fire Dept Head Qua Carmel Fire Dept Head Qua
2 Civic Square 2 Civic Square
CARMEL IN 46032-7543 CARMEL IN 46032-7543
USA USA
Payment Remittance Address: Wire Transfer Remittance: Overnight Remittance Address:
_ Arrow International, Inc. _ _Wells Fargo Bank N.A. _ _ __ _Wells Fargo Lockbox Services
PO Box 60519 420 Montgomery Street Arrow International, Inc.
Charlotte, NC 28260 - 0519 San Francisco, CA 94104 Lockbox 60519
Account No. 2000040988562 1525 West W.T. Harris Blvd - 2C2
Routing/ABA No. 121000248 Charlotte, NC 28262
SWIFT Code: WFBIUS6S
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1Z6069200372481939 Pre-pay & Add FOB ORIGIN Net 30 USD
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000010 9066-VC-005 EZ-STABILIZER(BOX OF 5) BX 2 0 75.00 150.00
Brand: Arrow
Batch No. 013633
Exp. Date 04/30/2018
Country of Origin TW
-Comments;--- —-- - -- -
Sub-Total 150.00
Freight 9.82
Tax 0.00
Total USD 159.82
The terms on our Acknowledgment and Invoices state Arrow's entire contract. Arrow shall not be bound by any different, additional or
conflicting terms and conditions contained in Buyer's Purchase Order unless expressly agreed to in writing by Arrow. Arrow's Acknowledgment
will not hereafter be subject to any change, modification or conflicting language without Arrow's prior written consent.
Arrow International,-Inc. EIN: 23-1969991
3015 Carrington Mill Blvd Morrisville, NC 27860 USA
Tel 800-523-8446 Fax
Email arrowcs@teleflex.com www.teleflex.com
VOUCHER NO. WARRANT NO.
ALLOWED 20
Arrow International
IN SUM OF $
3015 Carrington Mill Boulevard
Morrisville, NC 27560
$159.82
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#lrlTLE AMOUNT Board Members
1120 93109017 102-390.11 $159.82 1 hereby certify that the attached invoice(s), or
I
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 JON
f5 205I
Fire Chief
Title
I
Cost distribution ledger classification if
claim paid motor vehicle highway fund
I
Prescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF rCARMEL
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))
93109017 $159.82
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