HomeMy WebLinkAbout58496 HEART REACH MEDICAL LLC
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INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
58496
35-60000972
THIS NUMBER MUST APPEAR ON INVOICES, A/P
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
PURCHASE ORDER DATEDATE REQUIREDREQUISITION NO.VENDOR NO.DESCRIPTION
375705
7/31/202308/02/2332325Additional Equipment for Parks AED Units
Heart Reach Medical, LLC Administration Office
15147 Grassy Creek Ct. 1411 E. 116th Street
SHIP
Carmel, IN 46033Carmel, IN 46032
VENDOR
TO
CONFIRMATIONBLANKETCONTRACTPAYMENT TERMSFREIGHT
Net30
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION
6.000eachPower Heart G5 Pediatric Pads$ 105.000$ 630.00
GLAccount# 1125401-4239012
Send Invoice To:
$ 630.00
PLEASE INVOICE IN DUPLICATE
DEPARTMENTACCOUNTPROJECTPROJECT ACCOUNTAMOUNT
PAYMENT
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
AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS
I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
SHIP REPAID.
SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS.
Danny Griffin
ORDERED BY
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
Parks Operations Manager - Maintenance
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CONTROLLER
VENDOR COPY
DOCUMENT CONTROL NO.58496