248485 08/1 2/1 5 +ar C,AM
> CITY OF CARMEL, INDIANA VENDOR: 242000
;; ® l ONE CIVIC SQUARE PHYSIO CONTROL CORP CHECK AMOUNT: $*"'23,873.40"
�, r CARMEL, INDIANA 46032 12100 COLLECTIONS CENTER DRIVE CHECK NUMBER: 248485
'Mr e��� CHICAGO IL 60693 CHECK DATE: 08/12/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351501 24678 416018617 23,873.40 PM DEFIB
Please return top portion with payment.
AT SHIPPEDPURCHASE ORDER NUMBER SALES SERVICE REPRESENTATIVE m5 T``TA9CAB1 ....i.
07/21/15 L
24678 CELLPI EAL71 daemon 1003120155002/mj
CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS
GRD CO207339-00 Net 30 Days
::<`: »»: ...::: . :>>:::#3 X::#.• »::zs::: +EFf:.:PfF �.;:.;.;:.;:;;.;:.:.;:.; 34 f:.:T> ..fFE :.:Tf :
:.:.;;:.;: <:>:>::::::>z<:::>::>#:<:::#<:»:» 1?flt#1!«:»## # ::<::> :<#>#»»»:<:#::>:«:>:<::>::::: i ::t#3T3.... #1€�T.�uHF t ...... T
Elf........ i....Dig: f1 R::::::.::...........:.:::::i7£ ..............................................................................................................................................................#...........:::::......:.....................
(ANNUAL 23873 .40 T:>
FOR MAINTENANCE
AGREEMENT: PB18S636
PERIOD: 05/01/15
04/30/16
s:::a
Sub Total 23873 .40
Contact: Tom Small
Phone: 317-571-2.663 j
Fax._ tsmall@carmel .in.gov
Terms:
1Jo
151 DISCOUNT ON: ACCESSORIES
ACCESSORIES
CN,. 71ILL -ELECTRODES _. -. - .
*This contract :will be billed in 3; equal payments in. May of yea s
*2015`, 20.1;6, and 2017 for $23, 874. 00 . Amount is s ect t cha..ge if the
*contract 'changes in the future.
i
23873 .40 �.
Site: 20
* * * O R I G I N A L
v®
ACCEPTED
NOTE:TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN.
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))
416018617 $23,873.40
1 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
Physio Control
IN SUM OF $
12100 Collections Center Drive
Chicago, IL 60693
$23,873.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
24678 416018617 43-515.01 $23,873.40 I 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
AUG i 0 2015
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund