HomeMy WebLinkAbout108417 HEART REACH MEDICAL LLC
City of Carmel
EachEachEachEachSub TotalSub Total
Department:Account:Account:Fund:
1651652001XEKAED001BXELAED003CXELAED002BPowerheart G5 defibrillation pads - AdultShippingPowerheart G5 defibrillation pads - PediPowerheart G5 defibrillation pads - iCPR$194.40$100.00$60.00$88.00Page
1 of 1$38,880.00$14,520.00$63,300.00$9,900.00$100.00$100.00
111043-421.0042-390.12101General Fund
INDIANA RETAIL TAX EXEMPT
Send Invoice To:
CERTIFICATE NO. 003120155 002 0PURCHASE ORDER NUMBER
Carmel Police Department
108417
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
$63,400.00
PAYMENT
1/12/2023375705
* 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
15147 GRASSY CREEK CT 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 LABEL
Carmel, IN 46032-
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
CARMEL, IN 46033 - Don Kirch
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
Jim BarlowJames Crider
TITLE
73328ChiefDirector of Administration
108417
CONTROL NO.
CONTROLLER
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION