HomeMy WebLinkAbout106175 AFC INTERNATIONAL INC
City of Carmel
EachEachSub Total
Department:Account:Fund:
161MONITOR200Monitor 200 with accessoriesShipping$470.45$150.00Page 1 of 1$7,527.20$7,677.20$150.00
112044-670.04102Ambulance Capital Fund
INDIANA RETAIL TAX EXEMPT
Send Invoice To:
CERTIFICATE NO. 003120155 002 0PURCHASE ORDER NUMBER
Fire Department
106175
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
$7,677.20
PAYMENT
1/6/202200353173
* 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
A F C INTERNATIONAL INC Fire Department
*SHIP PREPAID.
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
VENDORSHIP
PO BOX 894 10701 N. College, Ste. A
*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
715C SW ALMOND ST Carmel, IN 46280-
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 194
DEMOTTE, IN 46310 -
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
Denise SnyderJames Crider
TITLE
62512Accreditation/Budget AdministratorDirector of Administration
106175
CONTROL NO.
CONTROLLER
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION