HomeMy WebLinkAbout111169 HEART REACH MEDICAL LLC
City of Carmel
EachEachEachSub Total
Department:Account:Fund:
111SS700VHMQuote #1388ShippingSaveStation 700 VHM Ventilated, Heated and Monitored$4,644.00$100.00$0.00Page 1 of 1$4,644.00$4,744.00$100.00$0.00
112044-670.99102Ambulance Capital Fund
INDIANA RETAIL TAX EXEMPT
Send Invoice To:
CERTIFICATE NO. 003120155 002 0PURCHASE ORDER NUMBER
Carmel Fire Department
111169
FEDERAL EXCISE TAX EXEMPT
35-6000972
210 Veterans Way
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
Save Station
$4,744.00
PAYMENT
4/30/2024375705
* 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 Fire Department
*SHIP PREPAID.
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
VENDORSHIP
15147 GRASSY CREEK CT 210 Veterans Way
*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 -
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
Denise Snyder
TITLE
86914Accreditation/Budget Administrator
111169
CONTROL NO.
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION