191806 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 364867 Page 1 of 1
0 ONE CIVIC SQUARE QUAD MED, INC. CHECK AMOUNT: $1,280.50
CARMEL, INDIANA 46032 PO BOX 550773
JACKSONVILLE FL 32255 -0773 CHECK NUMBER: 191806
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 50589 394.00 SPECIAL DEPT SUPPLIES
102 4239011 50646 886.50 SPECIAL DEPT SUPPLIES
Vist us at: INVOICE
QuodMed, www.quadmed.com Invoice Number: 50646
Emergency Medical Products sales @quadmed.com Invoice Date: Oct 22, 2010
Page: 1
P.O. BOX 550773
JACKSONVILLE, FL 32255 -0773
Voice: 800 933 -7334
Fax: 877- 367 -7759 Sales Order: 34280
CITY OF CARMEL FIRE DEPT CARMELFD
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL, IN 46032 CARMEL, IN 46032
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CARF,4EL -FE) lVAav ;Vet -30 -Days-
°:.Fi, i n 2 -�*e y�' s 3� ter* 33±
Sales Re ID Shi m flflethotl 3 Shi Date��� Due Date
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UPS Ground 10/22/10 11/21/10
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2.00 BOX EDI- 3001 -AV ACUVANCE 16G IV CATH 50 /BOX *MUST 98.50 197.00
BE 3342
4.00 BOX EDI 3002 -AV ACUVANCE 18G IV CATH 50 /BX *MUST 98.50 394 -00
BE 3355"
2.00 BOX EDI 3004 -AV ACUVANCE 22GX1 IV CATH 50 /BX **MUST 98.50 197.00
BE 3350
1.00 BOX EDI 3005 -AV ACUVANCE 24G IV CATH 50 /BX "MUST 98.50 98.50
BE 3353
Subtotal 886.50
Sales Tax 1
Total Invoice Amount 886.50
Check /Credit Memo No: Payment /Credit Applied
Freight
o"� 886 `50
Your balance as of Oct 22, 2010 is 2,265.50. This balance does not reflect payments or charges processed after that date.
Returned Goods Written authorization must be obtained prior to returning merchandise. Allretums shouldbe sent within 30 days in resalable condition. Returns are
subject to a 20'1 restocking charge. Merchandise held longer than 90 days, or custom items, are not returnable. All returned goods must be sent prepaid.
�k Vist us at: INVOICE
C1t dMed, Inc. www.quadmed.com Invoice Number: 50589
Emergency Medical Products sales @quadmed.com Invoice Date: Oct 21, 2010
h
Page: 1
P.O. BOX 550773
JACKSONVILLE, FL 32255 -0773
Voice: 800- 933 -7334
Fax: 877- 367 -77 Sales Order: 34280
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CITY OF CARMEL FIRE DEPT CARMELFD
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL, IN 46032 CARMEL, IN 46032
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Customer tD Customer P0a r e eef P rrtent Terms
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C ARMELFJ MAR}<- Net30 Days
Sales Fte `ID e a k
P �Ix SFiippi?9Metho[1,!.� hi
Date,, "uE Date
UPS Ground 10/21/10 11/20/10
fls' t a a° h .�..�x;�+7 m -rw x*e� .a wt''i
5hippeaUOM ��.em Desch tion a�Backordered '�UnitPnce��,4moun`t,
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BOX EDI- 3001 -AV ACUVANCE 16G IV CATH 501BOX" MUST 2.00 98.50
BE 3342
4.00 BOX EDI- 3002 -AV ACUVANCE 18G IV CATH 50 /BX *MUST 4.00 98.50 394.00
BE 3355
BOX EDI 3004 -AV ACUVANCE 22GX1 IV CATH 50 /BX *MUST 2.00 98.50
BE 3350
BOX ED[-30C)5-AV ACUVANCE 24G IV CATH 5016X **MUST 1.00 98.50
BE 3353
Subtotal 394.00
Sales Tax
Total Invoice Amount 394.00
Check /Credit Memo No: Payment /Credit Applied
Freight
39'00
Your balance as of Oct 21, 2010 is 1,379.00. This balance does not reflect payments or charges processed after that date.
Returned Goods Written authorization must be obtained prior to returning merchandise. All retums should be sent within 30 days in resalable condition. Returns are
subject to a 20% restocking charge. Merchandise heldlonger than 90 days, or custom items, are not returnable. All returned goods must be sent prepaid.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Quad Med, Inc.
IN SUM OF
P.O. Box 550773
Jacksonville, FL 32255 -0773
$1,280.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
1120 50589 102 390.11 $394.00 1 hereby certify that the attached invoice(s), or
1120 50646 102 390.11 $886.50 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
NOV 8 2010
fa
f
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))
50589 $394.00
50646 $886.50
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