HomeMy WebLinkAbout103889 BOUND TREE MEDICAL LLC
City of Carmel
EachEachEachEachEachEachSub Total
Department:Account:Fund:
1640205522360862114-082042114-082031772682305002745-10108Defib Pads - AdultSupraglottic Airway - Medium/LargeSupraglotic Airway - Small AdultSmart Capnoline Plus Non Intubated Oral Nasal
w/O2 Electrodes - Sensors MediumEKG Paper$240.40$935.00$479.60$102.00$14.65$14.80Page 1 of 1$14,960.00$19,649.00$1,202.00$2,398.00$204.00$592.00$293.00
112042-390.11102Ambulance Capital Fund
INDIANA RETAIL TAX EXEMPT
Send Invoice To:
Tubing - 100 Box
CERTIFICATE NO. 003120155 002 0PURCHASE ORDER NUMBER
Fire Department
103889
FEDERAL EXCISE TAX EXEMPT
35-6000972
2 Civic Square
THIS NUMBER MUST APPEAR ON INVOICES, A/P
ONE CIVIC SQUARE
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
CARMEL, INDIANA 46032-2584
Carmel, IN 46032-
SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
PLEASE INVOICE IN DUPLICATE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
DEPARTMENTACCOUNTPROJECTPROJECT ACCOUNTAMOUNT
EMS Supplies
$19,649.00
PAYMENT
3/23/202000352626
* A/P 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
BOUND TREE MEDICAL LLC Fire Department
*SHIP PREPAID.
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
VENDORSHIP
23537 NETWORK PLACE 2 Civic Square
*C.O.D. SHIPMENT CANNOT BE ACCEPTED.THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
TO
*PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
Carmel, IN 46032-
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 194
CHICAGO, IL 60673--1235
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
Denise SnyderJames Crider
TITLE
45411Accreditation/Budget AdministratorDirector of Administration
103889
CONTROL NO.
CONTROLLER
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION
Page 1 of 1$14,960.00$19,649.00$1,202.00$2,398.00$204.00$592.00$293.00
PURCHASE ORDER NUMBER
103889
THIS NUMBER MUST APPEAR ON INVOICES, A/P
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
AMOUNT
EMS Supplies
$19,649.00
* A/P 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
Fire Department
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
2 Civic Square
Carmel, IN 46032-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
James Crider
Director of Administration
EXTENSION