HomeMy WebLinkAbout106301 HEART REACH MEDICAL LLC (2)
City of Carmel
EachEachEachSub TotalSub Total
Department:Account:Account:Fund:
301010Powerheart G5 defibrillation padsPowerheart G5 AEDdiscount$1,645.00($100.00)$180.00Page 1 of 1$16,450.00$15,450.00($1,000.00)$5,400.00$5,400.00
111044-670.9942-390.12101General Fund
INDIANA RETAIL TAX EXEMPT
Send Invoice To:
CERTIFICATE NO. 003120155 002 0PURCHASE ORDER NUMBER
Carmel Police Department
106301
Accounts Payable
FEDERAL EXCISE TAX EXEMPT
35-6000972
3 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
$20,850.00
PAYMENT
2/17/2022375705
* 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
HEART REACH MEDICAL LLC Carmel Police Department
*SHIP PREPAID.
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
VENDORSHIP
58 11TH STREET NW 3 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
Carmel, IN 46032-
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 194
CARMEL, IN 46032 - Don Kirch
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
Jeffrey HornerJames Crider
TITLE
63575ChiefDirector of Administration
106301
CONTROL NO.
CONTROLLER
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION