188957 08/18/2010 CITY OF CARMEL, INDIANA VENDOR: 00352990 Page 1 of 1
ONE CIVIC SQUARE PRIORITY DISPATCH
CARMEL, INDIANA 46032 139 E SOUTH TEMPLE STE 500 CHECK AMOUNT: $2,180.00
SALT LAKE CITY UT 84111
CHECK NUMBER: 188957
CHECK DATE: 8/1812010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4357004 26856 2,180.00 EMD MED CARDSET
Date: 4/6/2010 1mrio am,
I N V I ®i ch
Attn: Accounting Department
139 East South Temple, Suite 500
Salt Lake City, UT 84111
�T
1V o 5 5 9 6 8 (801) 363 -9127 (801) 363 -9144 fax
(800) 363 -9127 toll -free
Customer Id: 740
Bill To: Carmel Clay Comm Ctr For: Carmel Clay Comm Ctr
Attn: Mindy Collins Attn: Dennis Stilts/ Mindy Collins
31 1st Ave NW 31 1st Ave NW
Carmel, IN 46032 -1715 Carmel, IN 46032 -1715
Phone: 317- 571 -2586 Fax: 317 571 -25851
Sales Contact: Jon Stones Base license: 0000OA01AE
Payment Method: Purchase Order Payment Terms: Net 30 Days
Qty Description Unit Price Extended Price
5 Cardset Medical v12.1 (Medical Standard North American English) 12.1 $395.00 $1,975.00
Protocol Cardset
5 ESP Medical Cardset (Medical Standard North American English) 12.0 $39.00 $195.00
Annual Maintenance Agreement for Medical Cardsets
Sub Total: $2,170.00
Tax: $0.00
Shipping Handling: $10.00
Total: $2,180.00
Amount due this Invoice: $2,180.00
Payment Method Details:
PO 26855
Online submitted order with Purchase Order;
Please pay this invoice in US Dollars. Make checks payable to Priority Dispatch Corporation.
"To lead the creation of meaningful change in public safety and health."
Page 1 of 1 Generated: 4!712010 7:58 AM
Ci of Car INDIANA RETAIL TAX EXEMPT PAGE
CERTIFICATE NO. 003120155 OD2 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 266
ONE CIVIC SQUARE 35- 60000972
CARMEI INDIANA 46032 2584 THIS NUMBER MUST APPEAR ON INVOICES, AIP
VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REOUIRED REQUISITION NO. VENDOR NO.
DESCRIPTION
4H2=10
Priority Dispatch Carmel Clay Communications
VENDOR Attrt• Accounting Dept SHIP 31 First Avenue NW
938 E. South Temple, Ste. 3 TO Carmel, IN 46032
Salt Lake City, UT 84149 (317) 571-25M
CONIRRR 110N BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43470.04
5 Each Adv EMD Med Cardset/Eng 02.0 $434.00 $2,170.00
Sub Total: $2,970.00
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Send Invoice To: .g F w,,' .•r3'.'�It
Carmel Clay Communications
31 First Avenue NW
Cannel. IN 46=-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECTACCOUNT AMOUNT
Communications PAYMENT $2,170.00
AP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THATTHERE ]SAN UNOBL,IGATED BALANCE IN
SHIP REPAID. THIS APPROPR TION SUFF IEN7 O P Y FOR THE ABOVE ORDER,
C.O.D. SHIPMENTS CANNOT BE ACCEPTED_
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY 7
SHIPPING LABEL$.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99. ACTS IW TITLE
AND ACTS AMENDATORY THEREOFAND SUPPLEMENT THERETO.
6
CL ERK-TREASURER
DOCUMENT CONTROL NO. VENDOR COPY
A
VOUCHER NO. WA ZRANT NO.
ALLOWED 20
Priority Dispatch
Attn: Accounting Dept IN SUM OF
139 E. South Temple, Ste. 5
Salt Lake City, UT 84111
$2,180.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# 1 Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
26856 55968 43- 570.04 $2,180.00 1 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
Wednesday, August 11, 2010
Director
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1955)
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))
04/06/10 55968 $2,180.00
1 hereby certify that the attached invoice(s), or bi(I(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer