HomeMy WebLinkAbout104310 CONVERUS INC
City of Carmel
EachEachEachEach Sub TotalSub Total
Department:Department:Account:Account:Fund:Fund:
10111Perpetual LicensesShippingEye Detect Station Version 4Training Certification$4,800.00$80.00$50.00$0.00 Page 1 of 1$4,800.00$4,850.00$800.00$800.00$50.00$0.00
112044-670.99112043-509.00101102General FundAmbulance Capital Fund
INDIANA RETAIL TAX EXEMPT
Send Invoice To:
CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
Carmel Fire Department
104310
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. DESCRIPTIONDEPARTMENTACCOUNTPROJECTPROJECT
ACCOUNTAMOUNT
Eye Detection Tests - Applicants
$5,650.00
PAYMENT
9/28/2020375179
* 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
CONVERUS INC Carmel Fire Department
*SHIP PREPAID.
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
VENDORSHIP
610 SOUTH 850 EAST 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 LABE
SUITE #4 Carmel, IN 46032-
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 194
LEHI, UT 84043 -
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
Denise SnyderJames Crider
TITLE
50056 Accreditation/Budget AdministratorDirector of Administration
104310
CONTROL NO.
CONTROLLER
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION