334113 01/04/19 (�� � CITY OF CARMEL, INDIANA VENDOR: 372494
® ONE CIVIC SQUARE MEDLINE INDUSTRIES, INC CHECK AMOUNT: $*******698.00*
�� !o CARMEL, INDIANA 46032 DEPT CH 14400 CHECK NUMBER: 334113
v\. /_ PALATINE IL 60055-4400 CHECK DATE: 01/04/19
M,irp`N c�.
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 1865879053 430.00 SPECIAL DEPT SUPPLIES
102 4239011 1866088812 268.00 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# 372494
MEDLINE INDUSTRIES, INC IN SUM O $ CITY OF CARMEL
DEPT CH 14400 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.
PALATINE, IL 60055-4400
Payee
$698.00
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
1865879053 42-390.11 $430.00 1 hereby certify that the attached invoice(s),or 12/20/18 1865879053 Misc.EMS Supplies $430.00
1120 102 Prior Year 1120 102
1866088812 42-390.11 $268.00 bill(s)is(are)true and correct and that the 12/22/18 1866088812 Misc,EMS Supplies $268.00
1120 102Prior Year materials or services itemized thereon for 1120 102
which charge is made were ordered and
received except
Thursday,January 3,2019
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
ORIGINAL
• www.medline,com y'
CUSTOMER.PO # INVOICE DATE INVOICE #
12212018 12/22/2018 1866088812
SOLD TO: SHIP TO: Page 1 of 1
CITY OF CARMEL
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SO 2 CIVIC SO
CARMEL, IN 46032-7543 CARMEL, IN 46032-7543
SALES REP# SALES ORDER# CARRIER FREIGHT TERMS I CUSTOMER# CURRENCY AMOUNT DUE
716 709124357 FEDEX GROUND MEDLINE 1746403 USD $268.00
Line Order Invoice Unit
No. Qty M Qty Item No / Description Code* Delivery # Price Amount
10 4.00 CS 4.00 VS311L TE 947467958 67.00 268.00r,--
/GLOVE,
68.00/GLOVE,EXAM,NITRILE,TXT,PF,LF,L
C
C
GROSS TAX AMOUNT FREIGHT TOTAL
268.00 0.00 0.00 268.00
Code
TE Tax Exempt
C Customer Freight
CUSTOMER SHALL PAY THE FREIGHT CHARGES INDICATED ON THIS INVOICE. ALL CLAIMS OF SHORT SHIPMENTS,MIS-SHIPMENTS AND OTHER ERRORS IN DELIVERY SHALL BE
COMMUNICATED TO MEDLINE IN WRITING WITHIN TWO BUSINESS DAYS OF THE INVOICE DATE,OR THEY ARE DEEMED WAIVED. ALL CLAIMS FOR PRICING AND BILLING ERRORS
-
-SHALL BE COMMUNICATED-TO-MEDLINE-IN-WRITING WITHIN 180-DAYS OF INVOICE-DATE,-OR THEY ARE-DEEMED WAIVED.------ - --
EXPORT PROHIBITED CONTRARY TO U.S.FEDERAL LAWS.NO RETURNS WILL BE ALLOWED WITHOUT WRITTEN AUTHORIZATION.(PH:800-307-8388)
INTEREST WILL BE CHARGED AT THE RATE OF 1.5%PER MONTH ON PAST DUE BALANCE.
MEDLINE INDUSTRIES,INC.INCLUDES MEDLINE INDUSTRIES,INC.AND/OR ITS WHOLLY OWNED CONSOLIDATED SUBSIDIARIES,MEDLINE INDUSTRIES HOLDINGS,LP,A DELAWARE
PARTNERSHIP,AND MEDCAL SALES,LLC,AN ILLINOIS LIMITED LIABILITY COMPANY,AS APPLICABLE. 002285P
Billing Inquiries: 1-800-388-2147, A/R Svcs Rep: Carly Luetzelschwab x7704271
ORIGINAL
.�-e
www.medline,com TJ.NVO I GE
CUSTOMER PO # INVOICE DATE INVOICE #
12182018 12/20/2018 1.865879053
SOLD TO: SHIP TO: Page 1 of 1
CITY OF CARMEL
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQ 2 CIVIC SQ
CARMEL, IN 46032-7543 CARMEL, IN 46032-7543
SALES REP# SALES ORDER# CARRIER FREIGHT TERMS CUSTOMER# CURRENCY AMOUNT DUE
716 709045797 FEDEX GROUND MEDLINE 1746403 USD $430.00
Line Order Invoice Unit
No. QtyU/M Qty Item No / Description Codes Delivery # Price Amount .
10 4.00 CS 4.00 IVSSTKI TE 947180177 107.50 430.00
/IV SECUREMENT KIT W/SORBAVIEW SHIELD C
t�
It.
e
It.
Is
GROSS TAX AMOUNT FREIGHT TOTAL
430.00 0.00 0.00 430.00
Code
TE Tax Exempt
C Customer Freight
CUSTOMER SHALL PAY THE FREIGHT CHARGES INDICATED ON THIS INVOICE. ALL CLAIMS OF SHORT SHIPMENTS,MIS-SHIPMENTS AND OTHER ERRORS IN DELIVERY SHALL BE
_--- COMMUNICATED-TO MEDLINE IN-WRITING WITHIN'TWO BUSINESS DAYS OF THE-INVOICE DATE,OR THEY ARE DEEMED WAIVED:-ALL-CL-AIMS-FOR PRICING-AND BILLING-ERRORS--- --
SHALL BE COMMUNICATED TO MEDLINE IN WRITING WITHIN 180 DAYS OF INVOICE DATE,OR THEY ARE DEEMED WAIVED.
EXPORT PROHIBITED CONTRARY TO U.S.FEDERAL LAWS.NO RETURNS WILL BE ALLOWED WITHOUT WRITTEN AUTHORIZATION.(PH:800-307-8386)
INTEREST WILL BE CHARGED AT THE RATE OF 1.5%PER MONTH ON PAST DUE BALANCE,
MEDLINE INDUSTRIES,INC.INCLUDES MEDLINE INDUSTRIES,INC.ANDIOR ITS WHOLLY OWNED CONSOLIDATED SUBSIDIARIES,MEDLINE INDUSTRIES HOLDINGS,LP,A DELAWARE
PARTNERSHIP,AND MEDCAL SALES,LLC,AN ILLINOIS LIMITED LIABILITY COMPANY,AS APPLICABLE. 002239P
Billing Inquiries: 1-800-388-2147, AIR- Svcs Rep: Carly Luetzelschwab x7704271