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ciCityof Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 103069
• ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
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
I
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO.. VENDOR NO. DESCRIPTION
8/15/2019 00352626 BP Cuffs
BOUND TREE MEDICAL LLC Fire Department
VENDOR 23537 NETWORK PLACE SHIP 2 Civic Square
TO Carmel, IN 46032-
CHICAGO, IL 60673--1235
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
38916
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 42-370.00
20 Each 2613-28148 BP Tubing $55.50 $1,110.00
Sub Total $1,110.00
Department: 1120 ('--und: 102 Ambulance Capital Fund
Account: 44-670.06
17 Each 2615-16019 BP Cuff $41.99 $713.83
17 Each 2615-16017 BP Cuff $29.15 $495.55
17 Each 16015 BP Cuff $26.50 $450.50
20 Each 2615-16013 BP Cuff $21.99 $439.80
20 Each 2615-16011 BP Cuff $18.99 $379.80
Sub Total $2,479.48
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Send Invoice To: ; ` _ __ , "
Fire Department
2 Civic Square
Carmel, IN 46032- ''``" v
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $3,589.48
SHIPPING INSTRUCTIONS *AIP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
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 LABE
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 194
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Denise Snyder ^
TITLE Accreditation Budget Administrator
CONTROL NO. 1 03069 CLERK-TREASURER