314921 8/15/2017 ,y W..4�gff
CITY OF CARMEL, INDIANA VENDOR: 354916
ONE CIVIC SQUARE K& R MEDICAL REPAIR CHECK AMOUNT: $*******968.00*
CARMEL, INDIANA 46032 3490 W SMITH VALLEY ROAD CHECK NUMBER: 314921
GREENWOOD IN 46142 CHECK DATE: 08/15/17
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
301 5023990 31671 968.00 OTHER EXPENSES
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08/10/2017 07:38AM 3178654001 K&R MEDICAL PAGE 01/02
' . 3490 W:Smith Valley Road
Greenwood, IN 46142
—t Phone: (317) 865-4000 INVOICE:
Equipment Repair Inc
f=ax: (317) 865-4001 -
°�" V www.kandrmedical,.com DAfF NUMBER
8/10/2017 31671
CASH CITY OF CARMEL
1402 CHASE DR.#I 10
CARMEL IN
317-571-2409 FAX
P.O.NUMBER TERMS SALES REP. SHIP/•DEL. DATE VIA PROJECT
!IM STEx3LING Due on receipt RG 8/101201ON-SITE
QUANTITY ITEM CODE DESCRIPTION UNIT PRICE AMOUNT
1 TBE-MID ... RITTER EXAM TABLE MODEL 204 900.00 900-DOT
1 FUEL.SURCH - FUEL SURCHARGE 5.00 : 5.00
SALES TAX 7.00% 63.00
Submitted To
AUG 10 2017 ,
CI
erk Treasurer
Warrallity ill repairs 90 days parte alad labor.
A service charge of 11/2%will be applied to any past due
balance.We also accept payments by Visa,MasterCard x966.00
MU
or Discover.30%restocking fee on all retumed purchases
and equipment.
Thank Yea for Yoar Basiness!
08/10/2017 07:38AM 3178654001 K&R MEDICAL PAGE 02/02
y 4:, 3490 W. Smith Volley Road
21
Greenwood, !N 46142E'
' phone: (317) 865,4000 •ORRID
`Equipment Repair inc Fax: (3.17) 865.4001
c www,kandrmedical.com DATE NUMSER
SERVICE ADIJOS�� Cr
P.O.NUftiIBER TERMS REQ.DATE ltEPRESENTATIVE' COMPLETED DATE
ITEM CODE DESCRIPTION QUANTITY
I
REPAIR SECTION
ITEM BEING REPAIRED MODEL NUMBER SERIAL NUMBER
i
i
WORK PERFORMED
Autoclave...
B/P Cuffs&Gauges... Microscope... Other...
❑ Cleaned ❑ Cleaned J Cleaned ❑ Parts on Order
❑ Calibrated p Calibrated Q Replace Bulb Part
Ron Test Cycle ❑ Replace Bulb/Valve Type Ship To Customer/Deliver
❑ Replace Gasket Tyoos/GM /ADC Service call... IN HOUSE Service...
❑
Replace Bellows_ Table... ❑
service Hours ❑ Servlce Hours
Replace Fill Filter ❑ Fixed Stirrup ❑ Mileage ❑ Other
Other ❑ Replace Bock Cylinder ❑ Other ❑ Other_
Other ❑ Replace Foot Cylinder ❑ Other ❑ Other
Description...
Signature 0 hf
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