HomeMy WebLinkAbout115372 ASCENSION ST VINCENT PUBLIC SAFETY - REVISED
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INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0PURCHASE ORDER NUMBER
City of Carmel
FEDERAL EXCISE TAX EXEMPT
115372
35-6000972
THIS NUMBER MUST APPEAR ON INVOICES, A/P
ONE CIVIC SQUARE
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
CARMEL, INDIANA 46032-2584
SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL - 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
2025 Yearly FF Physicals
1/24/2025372939
ASCENSION ST VINCENT PUBLIC SAFETY Carmel Fire Department
VENDORSHIP
PO BOX 778931 210 Veterans Way
TO
Carmel, IN 46032-
CHICAGO, IL 60677--8931
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS
FREIGHT
96880
QUANTITYUNIT OF MEASUREDESCRIPTIONUNIT PRICEEXTENSION
Department:Fund:
1120101General Fund
Account:
43-407.01
172EachFirefighter Physicals$601.70$103,492.40
Each
45Low Dose CT Scan$99.00$4,455.00
172EachPulse Advance Lipid Panel$23.80$4,093.60
Sub Total
$112,041.00
Send Invoice To:
Carmel Fire Department
Accounts Payable
210 Veterans Way
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENTACCOUNTPROJECTPROJECT ACCOUNTAMOUNT
$112,041.00
PAYMENT
* 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
*SHIP PREPAID.
AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
*C.O.D. SHIPMENT CANNOT BE ACCEPTED.THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
*PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
Denise SnyderZac Jackson
TITLEAccreditation/Budget AdministratorCFO
CONTROL NO.
115372