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HomeMy WebLinkAbout333191 12/11/18 �.. CITY OF CARMEL, INDIANA VENDOR: 242000 ONE CIVIC SQUARE PHYSIO CONTROL CORP CHECK AMOUNT: $****71,402.58* CARMEL, INDIANA 46032 12100 COLLECTIONS CENTER DRIVE CHECK NUMBER: 333191 ytraN�. CHICAGO IL 60693 CHECK DATE: 12/11/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4467099 102115 118088874 37,860.08 VIDEO LARYNGOSCOPES 102 4467099 102117 118089620 21,257.00 LIFEPAK CR PLUS AED'S 102 4463100 102116 118089634 11,053.80 3G MODEM PLUS SHIPPIN 102 4239011 118090001 1,231.70 SPECIAL DEPT SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 242000 PHYSIO CONTROL CORP IN SUM OF$ CITY OF CARMEL 12100 COLLECTIONS CENTER DRIVE 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. CHICAGO, IL 60693 Payee $21,257.00 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 102117 118089620 44-670.99 $21,257.00 1 hereby certify that the attached invoice(s),or 12/3/18 118089620 AED's $21,257.00 1120 102 1120 102 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 Monday, December 3,2018 � 9t_ David Haboush Fire Chief 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 5-11-10-1.6 120- Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Product Billing Page: 1 INVOICE ......:................::.;:.;:.;:.;:.;:.;.:.;:.;::.;.::.:;::.;::::: ;;.;;::;:.:;;:.:;:;:.;::::;:::;:.;:;.;:.;:.:.:::: >: :1Vlail: a:;i senfis:vfa::US:Ma�I;to:::th�s address onl. ........ :.;:.;p.: :.:;.;:.;;:.::;.;:.;:.;:.;:.;:.;:.;:.;;:.;:.;:.;:.;:.;::.:;:.;;:.;:.;:;.;:.::::::::.;;:.::::.;;:. .........I 1 > OQ> Itecti4ns:C.e to »:::>::3 118089620 Physio-Control, Inc. ;: .I a ::>IL:::6069 :........:<:::>:<:::>::»::: C....c::.9::: :::..::::::::::::::::::::::::::::. NE 11 11 Willows Road �`IIIf���������� s�;���'�������>������<��<�:c:�:�:�>:�>����:<�>:�»:�<��:�:<�>:;:.;:�_::: '���>:_>::�>:�>��:��;:�:�:�:<�:::��;:::�:�:`���>:":�>:���>:�:�>:�:::::: 8 PI..ease:::r:.efereneeInvoice3�I�.r::::oY�::1rrr►tr:c>teck::::<::': 11/26/18 Post Office Box 97006 1 I Redmond,WA 98073-9706 USA Fcr In u�r�es�. aEl toll $Q47 Telephone:425-867-4000...... ....::.__ __.-., : :-: :<u Fax:425-881-2405 F.E.I.N.91-0697691 BILL TO ACCOUNT: 10774201 SHIP TO ACCOUNT: 10774201 Sold To: 10774201 CARMEL FD CARMEL FD 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 UNITED STATES UNITED STATES -------------------------------------------------------------------------------------------------------------- Please return top portion with payment. - — - --- - B SALES SERVICE REPRESENTATIVE :'•EAFi4Bliiv.::'• iiC98AFiIiiiS :'•�Sii DATE SHIPPED PURCHASE ORDER NUMBER ! .................... ,.,,,•„ ,,,,•• ,•,,,...... . 11/26/18 102117 � CPGG07 EALL71 liyabjl ' 003120155002/mj CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS GRD SH00417030 S3932638-00 Net 30 Days _J :.;:.;:.;:.:•• :: ... .:: ::::>::::>::::»::>::::>:::<:::>::>:::». :.:::.;;:.:::::: .::.::.>::.>:.>;:.>:::>:;:::<:>::»::»::»>::>::>::::t3fE:t�#if3>::>: Nk:s»::! 1::$EIP.•:::`::>iF1`:: ES :>'::>:> #+1Ff:::P•.fE �................ #f..Fl�RF.......1tE.� R7RI,[7s;IR9iR:::::: ::::.::: ::; R3Pf1Li1E<: :::.::::::. u ... 1.f 8.04 03 000148; PAC.KAGE,LPCR,PLUS,SEMI 12: EA 12 : 0 2195 00 21072 '00 ` : ENGLISH,AHA2005, US Discount 439 .00- SIN: 47767723 Expires 08/01/2 47767724 Expires 08/01/2'- i47767725 8/01/2 47767725 Expires 08/01/2'- 47767726 8/01/2 47767726 Expires 08/01/2 !47767728 Expires 08/01/2 47767730 Expires 08/01/2' '- 47767733 Expires 08/01/2-- 47772994 8/01/2 47772994 Expires 08/01/2-- 47772995 Expires 08/01/2 47772996 Expires 08/01/2'- 47772997 8/01/2 47772997 Expires 08/01/2 47772998 Expires 08/01/2 Contact: JON THAN ALVERSON Phone: 3175 71.2 6 0 0 Sub Total 21072 . 00 s Freiglit a d Handling 185. 00 ¢00 50'922 I 21257. 00 Site: 15 * * * O R I G I N A L v® eN;y' 0 Y :P] ACCEPTED NOTE:TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN. VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 242000 PHYSIO CONTROL CORP IN SUM OF$ CITY OF CARMEL - 12100 COLLECTIONS CENTER DRIVE 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. CHICAGO, IL 60693 Payee $11,053.80 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 102116 118089634 44-631.00 $11,053.80 1 hereby certify that the attached invoice(s),or 12/3/18 118089634 Gateway Modem's $11,053.80 1120 102 1120 102 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Monday, December 3,2018 David Haboush Fire Chief hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 . ,20- Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Product Billing Page: 1 INVOICE ;Mai. a.► eiits::via:;115::Maii to;tk s adci ess:gnly. ........... ::?#?33 ;.,.;wive > > > > > ...... 118089634 > 'I >'OOCIfet©risGe�te.. Inc. Physio-Control, <`><> ' `' ............................................................... 9 ::::::.::::::::: ::::: ..............:::: Willows Road NE 11811 to :»E?: 1 FlasrfreceIn..:o.C ..............................................:.::.;:::.:::.. 11/26/18 Post Office Box 97006 ::�.:::::::::::::::::...::...:...:.i n WA 98073-9706 USA Redmo d ,'uirie$F:�ailtollar;re[1-80Q?;e#�G::..:..�...:::..::::....: Telephone:425-867-4000 ,,..,,.,....y..u.....,�.,—_.�uy._.u......u.y..............�.._.�.,......�.u.u..u•_,�.:::, ..... ....... . . Fax:425-881-2405 F.E.I.N.91-0697691 BILL TO ACCOUNT: 10774201 SHIP TO ACCOUNT: 10774201 Sold To: 10774201 CARMEL FD CARMEL FD 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 UNITED STATES UNITED STATES -------------------------------------------------------------------------------------------------------------- P/ease return top portion with payment. DATE SHIPPED PURCHASE ORDER NUMBER SALES/SERVICE REPRESENTATIVE 11/26/18 102116 CPGG07 EALL71 liyabjlF 003120155002/mj CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS GRD-NC SH00416869 53932885-00 INet 30 Days x)...... .:. .... 1 21996 Q00109 GATEWAY, ';WIRELESS;; TITAN 12` EA 12 0 � 10:35 00: 11053 :80 ' III, US Discount 113 .85- , S/N: IE0100ADF6 VE0100 F8 =100ADFC VE0100 FD �E0100ED4D VE0100E 50 >?>� IVE0100EDSI VE0100E 52 <'<? iVE01012C89 VE01016 DE �1TE 01016 CE 2 VE 01016 E3 ( Contact: JONATHAN ALVERSON Phone: 317.5 71.2 6 0 0 Sub Total 11053 . 80 Q0. 51359 11053 .80 Site: 15 V/SA' . ACCEPTED NOTE:TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN. VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 242000 PHYSIO CONTROL CORP IN SUM OF$ CITY OF CARMEL 12100 COLLECTIONS CENTER DRIVE 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. CHICAGO, IL 60693 Payee $1,231.70 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Terms Carmel Fire- Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 118090001 42-390.11 $1,231.70 1 hereby certify that the attached invoice(s),or 12/3/18 118090001 Misc.EMS Supplies $1,231.70 1120 102 1120 102 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 Monday, December 3,2018 David Haboush Fire Chief hereby certify that the attached invoice(s),or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 120- Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Product Billing Page: 1 iri. e. ri#s �S:;: : :: INVOICE ::- ; a .... ......:ad $ ;:;:;:;:;;: ... ..; I1g�90�0 1........:: ; e X. Physio-Control, Inc. :::: :::::.. Ctucaga•»I. >:6.069 .:::::::: .:::::::::::.:::::::::::::: 11811 Willows Road NE `:`:'e< 'feren a nvo"e> u e `ti 4`':rrur e k << <: 11/27/18 :...Pias...::i .:...:...:.n...: ..:.:..:.C..:1?I.............::........ Post Office Bax 97006 : Redmond WA 98073-9706 USA 7<> >< ;:n: ;: ;: ::o::....:......:. > FQrati uiries' 11.>tlisee1 $QO: 2 '8Q4................ Telephone:425-867-4000 Y,. u� ..._..... ,, Fax:425-881-2405 F.E.I.N.91-0697691 BILL TO ACCOUNT: 10774201 SHIP TO ACCOUNT: 10774201 Sold To: 10774201 CARMEL FD CARMEL FD 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 UNITED STATES UNITED STATES -------------------------------------------------------------------------------------------------------------- Please return top portion with payment. DATE SHIPPED PURCHASE ORDER N MBERSALES/SERVICE _SALES/SERV( E REPRESENTATIVE 11/27/18 QO0151694 CPGG07 EALL71 DOUMBGl • '�<<isY'�`?GA?4FS$L��:�3'r''r'?%><"'itaC�A$F::i'• �s�?? 003120155002/mj CARRIER 'CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS GRD SH00417147 S3933306-00 Net 30 Days ..:....#iRT tC7 x:1 li ER '> > s ? ''> T #ilk......AE<'< < << <>:«<> :>>>z :>:>'::>NNW: :.....:.:::::......:...:.........:.::.:..:.:::;...:;.:::.;;::::::::.. ..........::....:..::::..............::.::..:.: :. .::::.::.:.::.....::.,:..:.:::.::: : 1 11171-000037 RC`='4, PATIENT: CABLE, 4FT, 3 EA 3; 0 2;54 00 ( >647 70 T IOF 2406,ROHS Discount 38 .10-I L/C: 18H1S 3 2111:171.`90004.9 IR.AINBOW DCI ADT REUSABLE 1 EA 640 Q;0 544 >00 T< _. (SENSOR, REF 2696,ROHS Discount' 96 .00 L/C: '18JZJ 1 Contact: ANDREW YOUNG Phone: 317.!571.2600 Sub Total' 1191.70 Freight and Handling 40 . 00 - - --- - -- I j I i 1231.70 Site: 20 * * * O R I G I N A L ACCEPTED NOTE:TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN. VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER Vendor# 242000 PHYSIO CONTROL CORP IN SUM OF$ CITY OF CARMEL 12100 COLLECTIONS CENTER DRIVE 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. CHICAGO, IL 60693 Payee $37,860.08 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 102115 118088874 44-670.99 $37,860.08 I hereby certify that the attached invoice(s),or 11/30/18 118088874 Video Laryngoscopes $37,860.08 1120 102 1120 102 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Monday, December 3,2018 David Haboush Fire Chief I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 120— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer Page: 1 Product Billing _ - - INVOICE ` :.>:,>rnenfi`:` >Ikl["'i€ao a '^:address:>>< _> „::II;<,tions::'--'.6 r Drive?»> »> < <>?<>> 118088874 { Co t Physio-Control, Inc. e:::»> >::>::::>::;>::>;:::>::>::>:<.<.::>::»:::::>:::::: :_:««:;,:.:;:<:::: »:: . . . ..;:;::<:>::»:::::<:>::::>::>::>:................:><: :9.::::..::::::::;:;::::::::::::.:::::::::::::::::::::::::::::::::: 11811 Willows Road NE ::::::3 11/20/1 viii `r>"` <':'rur: Iieeks>::::>:::::<; 8 < Flesereferer�eIntiDi�e:N.........�.::btt.:..:............._-P .............. ost Office Box 97006 ::.....P:::::::.::::::::::.::::. 7 - SA Redmond WA 980 3 9706 U :... ::::::':�tir>In uiri s« all tb)1€see L 1w .......... w ,9.Telephone:425-867-4000 >uWz-sy .............. 3 Fax:425-881-2405 F.E.I.N.91-0697691 BILL TO ACCOUNT: 10774201 SHIP TO ACCOUNT: 10774201 Sold To: 10774201 CARMEL FD CARMEL FD 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 UNITED STATES UNITED STATES ------------------------------------------------------------------------------- ------- --- ---------------------- Please return top portion with payment. DATE SHIPPED PURCHASE ORDER NUMBER SALES/SERVICE REPRESENTATIVE X33: CA$l:E S: 11/20/18 102115 CPGG07 EALL71 liyabjl 003120155002/mj CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS GRD SH00416678 S3932675-00 Net 30 Days :ESIEgo. ! 5`.. 1.QP•. EG��.::::::::.::::::: f.:T�3i E:::::.:.•. �:.t...l 11996 0;00393 LARYNGOSCOPEVIDEQ, 16` EA 16': 0 28:05 00. 36801 60 ' ` CGRATH MAC EMS Discount 504 .90- 1 SIN: 1353046 Expires 10/01/1 1353048 Expires 10/01/1- J53049 0/O1/1'353049 Expires 10/01/1 353050 Expires 10/01/1 3 353051 Expires 10/01/1 VP I 1353052 Expires 10/01/1 I 353053 Expires 10/01/1 353054 Expires 10/01/1 353055 Expires 10/01/1 353057 Expires 10/01/1 353060 Expires 10/01/1 353062 Expires 10/01/1 353064 Expires 10/01/1 353066 Expires 10/01/1 ,353067 Expires 10/01/1 1353070 Expires 10/01/1 ---:2::: 11;996 Q0039�k: ATTERY,;LARYNGOSCOPE, l EA L :; 0 62 OQ; 53 94 T ...: CGRATH MAC EMS Discount 8 .06- L/C: 9344002-02 Expires: 09/12/19 1 3 11.996 b00398BLADES,LARYNGOSCOPE,X3 ` 1`. EA l' 0 2:86 OQ; IBOX OF 10 Discount 37.18- *** CONTINUED *** ACCEPTED NOTE:TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN. Product Billing Page: 2 INVOICE >IVlai[> lea#>:<»via<:`l}5>M`ii<atis:addres>: 'ni:`.`:? ' € €€12> a(3Go1 ect©ns:Cer�1e.. rive.......................... 118088874 Physio-Control, Inc. 11811 Willows Road NE >Pleasl:reference:>Irvoee:> Itir:on:`.iur:cecl;�::>:::: 11/20/18 Post Office Box 97006 :.;:.;:; .:.;:.::........................... Redmond,WA 9807 - :::: ed d 3 9706 USA >.Fa In ................ iriesG211.... lLts k..8©0:? '.8Q? ?? >::::::>::::: :.::.::.:.:::.::::.:;.::.;::.;:.;;:.; Telephone:425-867-4000 y_ .. _ *: Fax:425-881-2405 F.E.I.N.91-0697691 BILL TO ACCOUNT: 10774201 SHIP TO ACCOUNT: 10774201 Sold To: 10774201 CARMEL FD CARMEL FD 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 UNITED STATES UNITED STATES -------------------------------------------------------------------------------------------------------------- Ptease return top portion with payment. DATE SHIPPED PURCHASE ORDER NUMBER SALES/SERVICE REPRESENTATIVE 11/20/18 102115 � CPGG07 EALL71 liyabjl 003120155002/mj CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS GRD SH00416678 53932675-00 Net 30 Days :r:�,>:."-.-.::::..:::::::;;::. ...::;?:.-:.>-•':'-':::::.i'•>:'::isi' i'i`-:>::i:asisi'•::'iiii:%EiEi: ::..:,----:.-.::•'err':i':asi:`;'..»:.,..,..:.,. :i:i:::<"'•::;ii:::-.-•-'- }:,':.—::-;::""r•.'i:':?EiEzi::::is:.,:..":,'";•:,'.^:::::i:i ii:•;`•:.. Tit i7C,x.1V........... iii£,4#i ixFlt?est::::::::::::::::::.:::::::::::::::::::::::::.: } L/C: 1808031 Expires: 08/03/21 1 4 11996-O'O'0413 LARYNGOSCOPE,BLADES,MAC 1 EA 1' ' 0 `' 1:64 00 142 '68 T 1,BOX OF 10 Discounts 21.32- L/C: P17121304 Expires: 12/13/20 1 >5 119,96 .000414;;: LARYNGOSCOPE,BLADES,MAC 1 EA .... 2,BOX OF 10 Discount 21.32- L/C: 18080803 Expires: 08/08/21 1 6 11996 0:00415; LARYNGOSCOPE,BLADS,MAC l :EA 1: 0 1:64 00, 142 68 T 3,BOX OF 10 Discount 21.32- L/C: 18051502 Expires: 05/15/21 1 7 11996 000416 LARYNGOSCOPE,BLADES,MAC EA-— 1;, 0 ! 164 00 142 68 T 4,BOX OF 10 Discount 21.32- L/C: 18061401 Expires: 06/1 /21 1 Contact: JON THAN ALVERSON Phone: 317.571.2600 Sub Total 37675.08 Frei t and Handling185. 00 *** CONTINUED *** M ACCEPTED NOTE:TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN. Page: 3 Product Billing M _ _ INVOICE IVIaiF>"`a>'rixent''`iia'US:N[ ``""atl`r`s R.:Y.:::..... ..::::::::.:::::::::: :X.:::::::::. Ig Col1e'.ctbns':`:Ge>3te.:Dc�..e.................. .... 118088874 ...........:;:...... Physio-Control, Inc. Y :::::.9:::•::::::::::::::::::::: ::::.::: . 11811 Willows Road NE ::::::::::::.............:....>::::::::............>::::::::::::......:;......;:::....... ::=: Pies re:.....�renc :Intoe �iuEtii..........::. .::.......: ...:::.::..: /20/18 Post Office Box 97006 ;;!.::;::::;;;;:;;::::;:::::;::::;;jj n W 98073-9706 USA :<:>:aj Redmond, A >Fr>lt`uafl>tali<€s1=$OOG'.8Q?................ ::>:.;:;;.::.; :.::.;:;;.;:.;:.;;:.;:.;:;.;;:.;:.;:.;:.;:.;:.;:.:::.:::.;:.;:.::.:::�.::.;:.;:.;;;:.;:.;:.;:.;:.;:.;:.;:.;:.;:.;:. Telephone:425-867-4000 _.::;::: :. uLL:. :::::: ::.:::::::::.0 ::;:� Fax:425-881-2405 F.E.I.N.91-0697691 BILL TO ACCOUNT: 10774201 SHIP TO ACCOUNT: 10774201 Sold To: 10774201 CARMEL FD CARMEL FD 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 UNITED STATES UNITED STATES ----------------------- -------------------------------------------------------------- ----- --------- Please return top-portion with payment. DATE SHIPPED PURCHASE ORDER NUMBER SALES/SERVICE REPRESENTATIVE '=' 149(FiBI:€�? :ff'.:ffJClAB :':<:": 11/20/18 102115 ICPGG07 EALL71 liyabjl 003120155002/mj CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS GRD SH00416678 53932675-00 Net 30 Days -.-:.::::.;_:::.33? ::: '#t3TYl3 (VE #7S!�iFiF' fYBL? SE: '............... ET PfE f iT$(E TtB I Q00150915 37860 .08 Site: 15 * * * O R I G I N A L v7SA' ACCEPTED NOTE:TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN.