181358 01/13/2010 CITY OF CARMEL, INDIANA VENDOR: 242000 Page 1 of 1
ONE CIVIC SQUARE PHYSIO CONTROL CORP CHECK AMOUNT: $17,499.90
1 ro CARMEL, INDIANA 46032 1 2100 COLLECTIONS CENTER DRIVE
r o b At CHICAGO IL 60693 CHECK NUMBER: 181358
CHECK DATE: 1/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 R4351501 12668 PH694022 17,499.90 MAINTENANCE CONTRACT
U■ It JMlYYCU IUHUHA,L UHUtH NUMUtFI SALtS!`.+tHVK;t HtPHtStN 1 A I IVt
12/23/09 12688 CSPPP1 EALL71 1 003120155002/mj
CARRIER I CARRIER TRACKING NUMBER I SALES ORDER PAYMENT TERMS
GRD I C0132355 -00 Net 30 Days
ANNUAL 17499.90 :OA
FOR MAINTENANCE
AGREEMENT: PB11Y043
PERIOD: 11/01/09
10/31/10
Sub Total 17499.90 MO
Con actl Mark Hulett
Phone 317. 571' =2663;
I 317 571 =2615-
Terms
10 %�DISCOUNT ACCESSORIES
5 DISCOUNT :ON DE�r iB ELECTRODES
PLEASE =E MAIL INVUICEASAP TO
]Dni�IS>J. 'S�dYDER AT: dsnyder @cartne in
CCR 12 !22.09.
I 17499.90
Sit e: 20
O R I G I N A L
VISA iwasteQ
ACCEPTED
NOTE: TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Physio Control
IN SUM OF$
12100 Collections Center Drive
Chicago, IL 60693
$17,499.90
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
12668 PH694022 43- 515.01 $17,499.90 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
JAN 11 2010
fM
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
PH694022 $17,499.90
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer