HomeMy WebLinkAbout102131 HENRY SCHEIN INC INDIANA RETAIL TAX EXEMPT Page 1 of 1
City of Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 102131
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AP
CARMEL, INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
11/19/2018 357526 Stethoscopes
HENRY SCHEIN INC Fire Department
VENDOR DEPT CH 10241 SHIP 2 Civic Square
TO Carmel, IN 46032-
PALATINE, IL 60055--0241
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
31180 I
� QUANTITY j UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-670.06
5 Each 1141017 Electronic Littmann 3200 Stethoscope $403.00 $2,015.00
Sub Total $2,015.00
gg ,
tu.
1
Send Invoice To: ° ,,,;1:
Fire Department
2 Civic Square
x .
Carmel, IN 46032- ra
PLEASE INVOICE IN DUPLICATE
L _ DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT 1 AMOUNT
PAYMENT $2,015.00
'AVP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
'C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL - .•
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 4.C..)
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
ORDERED BY 'W —
Denise Snyder \\‘%,
TITLE Budget&Accreditation Manager
CONTROL NO. 102131 CLERK-TREASURER