HomeMy WebLinkAbout185632 05/26/2010 CITY OF CARMEL, INDIANA VENDOR: 364140 Page 1 of 1
i ONE CIVIC SQUARE ALL MED CHECK AMOUNT: $93.00
CARMEL, INDIANA 46032 4715 SCRUGGS STATION ROAD
sx� JEFFERSON CITY MO 65109 CHECK NUMBER: 185632
CHECK DATE: 5/26/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 854827 93.00 MATERIALS SUPPLIES
INVOICE
r 4715 Scruggs Station Rd. INVOICE
Jefferson City, MO 65109 854827
phone: 888 633 -6908 Invoice Date Page
fax: 800 -425 -5633 5/10/2010 11:39:53 1 of 1
A division of Alliance Medical, Inc.
ORDER NUMBER
www.AliMed.net 126163
Bill To: Ship To:
City of Carmel Utilities Carmel WWTP
Wastewater 9609 Hazel Dell Parkway
760 Third Ave. SW, Ste. 110 Indianapolis,lN 46280
Carmel, IN 46032 USA
USA
Customer ID: 57405
PO Number Terms Description Net Due Date Disc Due Date Discount Amount
Jeff Cooper Net 30 06 /09/10 06/09/10 0.00
Order Date Pick Ticket No Primary Salesrep Name Taker
5/5/2010 08:49:38 174392 Randy DeGolyer PETERSN
Quantities Pricing
Rent ID UOM Unit Extended
Ordered Shi ed Remuinin UOM Item Description Price Price
1 P UnitSl7.e q Unit Size
Order Note: order by phone Jeff
Carrier: Tracking 1 Z6715990360559668
2.000 2.000 0.000 PR 10805 PR 45.000 90.00
1.0 WELCHA 00185 -3 dctib pads w /cable 1
monitor defib, PIC50, defib pads w /cable
Tolal Lines: I SUB- TOTAL: 90.00
TAX. 0.00
FUEL: 3.0
AMOUNT DUE: 93.00
VOUCHER 105478 1 JVARRANT ALLOWED
:364140 IN SUM OF
ALL MED
4715 SCRUGGS STATION ROAD
JEFFERSON CITY, MO 65109
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
854827 01- 7202 -05 $93.00
Voucher Total $93.00
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
364140
ALL IVIED Purchase Order No.
4715 SCRUGGS STATION ROAD Terms
JEFFERSON CITY, MO 65109 Due Date 5/17/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/17/2010 854827 $03.00
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
C-4 V n—
Date Officer