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HomeMy WebLinkAbout192198 11/23/2010 CITY OF CARMEL, INDIANA VENDOR: 242000 Page 1 of 1 ONE CIVIC SQUARE PHYSIO CONTROL CORP 0 12100 COLLECTIONS CENTER DRIVE CHECK AMOUNT: $316.00 CARMEL, INDIANA 46032 CHICAGO IL 60693 CHECK NUMBER: 192198 CHECK DATE: 11/23/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4237000 411019640 50.00 REPAIR PARTS 1120 4237000 411019698 266.00 REPAIR PARTS Please tetum top po 1. yment- .co o REPRESENTATIVE f f 5 :yi�,.�, z. ^x ?,:e•'.•ss.:,; p DATE SH;PFED PURCHASE ORDER NUNTER SALES..._PMCE REPRESENTATIVE )1JCRB P?�.- ..:,;,c5:;.:3 ill /03/10 Mark Hulett EALL72 Finnegan 00312015500 i CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS GRD R2290630 --00 Net 30 Days ,yi c::�, 0i ,i y :itk;: �.y.f�: :yi.: .i ii::i::i:::: y p v :i,:i:.ii_.:..:::: C::: /:W� {:�4: %:::ii':::•1:��." ..!`.�G:.:� ��4, f. Y�T.! gflii�!' t ........:............�'.[1..... �.i.�I..l!... CONTRACT Regular Travel 0.7 0.00 0.00 Sub Total 50.00 REF S IR: R2290630 DATE COMP: 11/03/10 CONTRACT: PB11Y043 I iL 50.00 Site: 20 O R I G I N A L v /SA ACCEPTED NOTE: TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN. 4. Delivery Unless otherwise indicated in this document, delivery shall be FOB Physic point of shipment and title and risk of loss shall pass to the Purchaser at that point. Partial deliveries may be made and partial invoices shall be permitted and shall become dur; in accordance with the payment terms. In the absence of shipping instructions from the Purchaser, Physic will obtain transportation on the Purchaser's behalf and for the Purchaser's account. Excess charges for expedited delivery are the responsibility of the Purchaser unless specifically waived by Physio. ARRANGEMENT FOR INSURANCE OF MERCHANDISE IS THE RESPONSIBILITY OF THE PURCHASER. 5. Delays Delivery dates are approximate. Physio will not be liable for any loss or damage of any kind due to delays in delivery or non- delivery resulting `ron] any cause beyond its reasonable control. including but not limited to, acts of God, labor disputes the requirements of any governmental authority, war, civil unrest delays in manufacture.. obtaining any required license or permit, and Physio inability to obtain goods from its usual sources. Any such delay shall not be considered a breach of Physio and the Purchaser's agreement and the delivery dates shall be extended for the length of such delay. 6. Inspection and Acceptance Claims by the Purchaser for damage to or shortages of goods delivered shall be made within thirty (30) days after shipment by providing Physio with written notice of any deficiency. In the absence of such notice, Physio will deem products and services accepted by Purchaser Payment is not contingent upon immediate correction of any deficiencies and Physio prior approval is required before the return of any goods to Physio. T. Warranty Physio warrants its products in accordance with the terms of the standard Physio product warranty applicable to the product to be supplied, and the remedies provided under such warranty shall be the Purchaser's sole and exclusive remedies. The warranties set forth therein are conditioned upon the proper use and maintenance and conformance with any applicable recommendations of Physio and upon Purchaser promptly notifying Physio of any defects. Physio makes no other warranties, express or implied, including, without limitation, NO WARRANTY OF MERCHANTABILIJt OR FITNESS FOR A PAHTICULAR PURPOSE AND IN NO EVENT SHALL PHYSIO BE LIABLE FOR INCIDENTAL, C;ONSEOIJEN FIAL, SPECIAL OR OTHER DAMAGES, H. Non Warranty Service Non Warranty service is available by contacting a district office or the headquarters of Physio. All risk of loss, damage, freight and other costs for shipment to and from the point of repair shall be the responsibility of the Purchaser. 9. Patent Indemnity Upon receipt of prompt notice trorn the Purchaser and with the Purchaser's authority and assistance, Physic agrees to defend. indemnify and hold the Purchaser harmless against any claim that the Physio products cohered by this document directly infringe any duly issued United States of America patent. 10. Third tarty Liability Physio shall not be liable for and Purchaser shall hold Physio harmless from any liability sustained in favor of third parties arising from or during Purchaser's possession, use or sale of Physic equipment except to the extent that such liability arises solely from Physic's negligence. Physio shall not be liable; for and Purchaser shall hold Physio harmless from any liability for consequential damages sustained by Purchaser including those arising from or measured by lost profits under its contracts with third parties. 11. Miscellaneous a) The Purchaser agrees that products purchased hereunder will not be reshipped or resold to any persons or places prohibited by the laws of the United States of America. h) Through the purchase of Physio products, the Purchaser does not acquire any interest in any tooling, drawings, design information, computer programming, patents or copyrighted or confidential information related to said products and the Purchaser expressly agrees not to reverse engineer or decompile such products or related software and information. cj Physio shall have the right to cancel or suspend this Agreement at any time upon Purchaser making an assignment for the benefit of creditors or becoming bankrupt or insolvent, or upon a petition being filed in a court of competent jurisdiction proposing the appointment of a receiver or that Purchaser is adjudicated bankrupt or insolvent or reorganized under the provisions of any applicable bankruptcy or insolvency law. d) In addition to the rights and remedies reserved herein. Physio shall have all the rights and remedies conferred by law and shall not be required to proceed with performance of the contract arising herefrom it Purchaser is in default to Physio under this or any contract. e) The rights and obligations of Physio and the Purchaser related to the purchase and sale of products and services described in this document shall be governed by the laws of the State of Washington, United States of America. All costs and expenses incurred by Physio related to enforcement of its rights under this document, including reasonable attorney's fees. shall be reimbursed by the Purchaser. 02007 Physic Control, inc., a d'lvision of Med.rcnic. MIN 3201819-00'. 1 CAT 26500- 002709 Please return top portion wirn paymem. PURCHASE O RDER NUMBER E SALES SERJICE REPRES�NTATIV� 3•".. aAY'{ 1ES...::::•:.. I4..:E7@��IStB?1''i`�'::::., DATE oHIPPEC: 0 11/03/10 Mark Hulett EALL71 McWillia 003120155002/mj CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS GRD R6045912 -00 Net 30 D ays I r >.;�s 6; ?��a -i�: s c:- <.y >>t� ?f�> >f�:��i �h:ar;l�t: <,�f::r:::.::.' .,7, 2 ttc °.r .'l :;::::i: >:<;a •"�ai:i :::::OEI::PttEG :1 t t� :.:::.31 t�i�4t"' trQ�l�:>:.:: >::.....'t.�'.�3#�3 FX, RED, B, NIBP, CO2 L _..,y... .._....._....w. S/N:12984817 CONTRACT Regular Labor 0.8 0.00 0.00 �1 5 99400 .000165,1 ,LPl2i', EN, P, SP02, 12L, 100M, IFX,AED,B,NIBP,CO2,L S/N:12984816 =1 CONTRACT Regular Labor 0.8 0.00 0.00 6 99..401 000618 >siLIFEPAK:'S0.0. AED, 2- Button Operation, ADAPTIV Biphasic S/N:31516822 CONTRACT Regular Labor 0.4 0.00 0.00 7 99401, 00.0390'. LIFE'PAK ;500 A:ED,. 2 Button 3 {Operation, ADAPTIV Biphasic S/N:13736712 CONTRACT Regular Labor 0.4 0.00 0.00 8 99400- 000347.LP12 >DEFIB /.MON, ADAPTIU Biphasic, AED, EL Screen, Pacing, SPo2, 12Lead, Fax, NIBP, ETCo2, 100mm Printer S/N:30678995 CONTINUED y— ACCEPTED NOTE: TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN. 4. Delivery Unless otherwise indicated in this document, delivery shall be FOSS Physic point of shipment and title and risk of loss shall pass to the Purchaser at that point. Partial deliveries may be made and partial invoices shall be permitted and shall become due in accordance with the payment terms. In the absence of shipping instructions from the Purchaser Physio will obtain transportation on the Purchaser's behalf and for the Purchaser's account. Excess charpes for expedited delivery are the responsibility of the Purchaser unless specifically waived by Physio. ARRANGEMENT FOR INSURANCE OF MERCHANDISE IS THE RESPONSIBILITY OF THE PURCHASER. 5, Delays Delivery dates are approximate. Physio will not be liable for any loss or damage of any kind due to delays in delivery or non delivery resulting from any cause beyond its reasonable control, including but not limited to, acts of God, labor disputes, the requirements of any governmental authority, war. civil unrest, delays in manufacture, obtaining any required license or permit. and Physio inability to obtain goods from its usual sources. Any such delay shall nol be considered a breach of Physio and the Purchaser's agreement and the delivery dates shall be extended for the length of such delay. 6- Inspection and Acceptance Claims by the Purchaser for damage to at shortages of goods delivered shall be rnade within thirty (30) days after shipment by providing Physic with written notice of any deficiency. In the absence of such notice. Physio ,vill deem products and services accepted by Purchaser Payment is not contingent upon immediate correction of any deficiencies and Physio prior approval is required before the return of any goods to Physio. 7. Warranty Physio warrants its products in accordance with the terms of the standard Physio product warranty applicable to the product to be supplied, and the remedies provided under such warranty shall be the Purchaser's sole and exclusive remedies. rho warranties set forth therein are conditioned upon the proper use and maintenance and conformance with any applicable recommendations of Physio and upon Purchaser promptly notifying Physio of any detects. Physio makes no other warranties, express or implied, including, without limitation NO WARRANTY OF MERCHANTABILI T Y OR FITNESS FOR A PARTICULAR PURPOSE AND IN NO EVENT SHALL PHYSIO BE LIABLE FOR INCIDENTAL CONSEOUENTIAL, SPECIAL OR OTHER DAMAGES. 6. Non- Warranty Service Non- Vi /arranty service is available by contacting a district office or the headquarters of Physic, All risk of loss, damage, freight and other costs for shipment to and from the point of repair shall be the responsibility of the Purchaser. 9. Patent Indemnity Upon receipt of prompt notice from the Purchaser and with the Purchaser's authority and assistance, Physio agrees to defend, indemnify and Bold the Purchaser harmless against any claim that the Physio products covered by this document directly infringe any duly issued United States of America patent. 10. Third Party Liability Physio shall riot be liable for and Purchaser shall hold Physio harmless from any liability sustained in favor of third parties arising from or during Purchasers possession, use or sale of Physic equipment except to the extent that such liability arises solely from Physio`s negligence. Physio shall not be liable tar and Purchaser stall hold Physio harmless from any liability for consequential damages sustained by Purchaser including those arising from or measured by lost profits under its contracts with third parties. 11. Miscellaneous a) The Purchaser agrees that products purchased hereunder will not be reshipped or resold to any persons or places prohibited by the laws of the United States of America. bi Through the purchase of Physio products. the Purchaser does not acquire any interest in any tooling, drawings, design information, computer programming, patents or copyrighted or confidential information related to said products and the Purchaser expressly agrees not to reverse engineer or decompile such products or related software and information. c) Phvsio shall have the right to cancel or suspend this Agreement at any time upon Purchaser making an assignment for the benefit of creditors or becoming bankrupt or insolvent, or upon a petition being filed in a court of competent jurisdiction proposing the appointment of a receiver or that Purchaser is adjudicated bankrupt or insolvent or reorganized Linder the provisions of any applicable bankruptcy or insolvency law. d) In addition to the rights and remedies reserved herein, Physic shall have all the rights and remedies conferred by law and shall not be required to proceed with performance of the contract arising herefram if Purchaser is in default to Physio under this or any contract, a) The rights and obligations of Physio and the Purchaser related to the purchase and sale of products and services described in this document shall be governed by the laws of the State of Washington, United States of America. All costs and expenses incurred by Physic related to enforcement of its rights under this document, including reasonable attorney's fees, shall be reimbursed by the Purchaser. X2007 Physio- Convot. Inc. a divislof of Medtrenic. MIN 320181 -001 1 CAT 26500- 002709 Page: 1 Physio- Control, Inc Service Report Billing INVOICE I IVIaf1 payments only to this address 3 12100.C�Ilec #,o ns C eiites Drive 411019698 Formerly Medtronic ERS C ca n jD EiO3 I 11811 Willows Road NE 9 I Post Office Box 97006 Phase reterence'Invofce lumber an y o cheek 1 1103110 Redmond, WA 98073 -9706 USA FLSC l#t[{li�rle$ Gall #011:free 1 8Q4 Telephone: 425 -867 -4000 Fax 425 -881 -2405 F.E.LN. 91- 0697691 BILL TO ACCOUNT: 10774201 SHIP TO ACCOUNT: 10774201 Sold To: 10774201 CARMEL FIRE DEPARTMENT CARMEL EIRE DEPARTMENT 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 UNITED STATES UNITED STATES Please return top portion with payment. DATE'SH;PFE- ,7:.nAEE ORDER NUMDSF SA�ES:SEi V l,_ :ci•.:. ."i .'JT �+TiVC' r 111/03/10 Mark Hulett EALL71 McWillia 1 CARRIER CARRIER TRACKING NUMBER SALES ORDER ;PAYMENT GRD R60459 -00 Net 30 i� i 'a# 13( II: f! a si'!; Ei' :'�i: >'•i?:i? >i'i t: r'—:,...,—:.;,..,;.';:.:;.:::.,,;' r isEii> i?` E r 1 .9.9400 .0;008.21: LP12 DEFIB /MON, ADAPTLV T Biphasic, AED, EL Screen, i Pacing, SPo2, 12Lead, Fax, NIBP, ETCo2, Trending, 100mm Printer i S/ N: 31516 3 8 9 3006241 -47 LABEL- 13EZEL,ECG,SP02 1.0 0.00 0.00 3012128 -000 CONN PNEUMATIC COULE 1.0 0.00 0.00 I 3012120 -004 COVER CO2 CONNECTO 1.0 0.00 0.00 :3 CONTRACT Regular Labor 0.8 0.00 0.00 2 NON;:DEVICE SERVICE ACTIVITY 3009376 -005 L NICD BATTERY 13.0 0.00 0.00 3208231 -000 KIT -LIS02 BATTERY RE 1.0 0.00 0.00 3208231 -000 KIT -LIS02 BATTERY RE 3..0 0.00 0.00 CONTRACT Regular Labor 0.5 0.00 0.00 3 °94C0 v:b0821< 1LP�2 DE�IB,!MON,..ADAPT.IV I 3 Bip.iasic, AED, ELL Screen, IL IPacing, SPo2, 12Lead, Fax, NIBP, ETCo2, (Trending, 100mm Printer S/N:31516389 CONTRACT (Regular Labor 0.8 0.00 0.00 <:4 99400 000165 ILP12„ EN,:.P, SP02, 12`1;; 1`0.OM, I ;a CONTINUED v ACCEPTED NOTE: TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN. 1. General Terms Physio- Control, Inc. "Physio acceptance of the Purchaser's order is expressly conditioned on the Purchasers assent to the terms set forth in this document and its attachments. Physio agrees to furnish the goods and services ordered by the Purchaser only on these terms, and the Purchasers acceptance of any portion of the goods and services covered by this document shall confirm their acceptance by the Purchaser. These terms constitute the complete agreement between the parties and they shall govern any conflicting or ambiguous terms on the Purchaser's Purchase order or on other documents submitted to Physio by the Purchaser. These terms may not be revised in any manner without the prior written consent of an officer of Physio. 2, Pricing Unless otherwise indicated in this document, prices of goods and services covered by this document shall be Physio standard prices in effect at the time of delivery. Prices do not include freight insurance, freight forwarding fees, taxes, duties import or export permit fees, or any other similar charge of any kind applicable to the goods and services covered by this document. Sales of use taxes on domestic (USA) deliveries will be invoiced in addition to the price of the goods and services covered by this document unless Physio receives a copy of a valid exemption certificate prior to delivery. Please forward your tax exemption certificate to the Physio Tax Department P.Q. Box 97006, Redmond Washington 9€3073 -9706 3. Payment Unless otherwise indicated in this document or otherwise confirmed by Physio in writing, payment for goods and services supplied by Physio shall be subject to the following terms: Domestic (tJSA) Sales Upon approval of credit by Physio. 100% of invoice due thirty (30) days after invoice date. international Sales Sight draft or acceptable (confirmed) irrevocable letter of credit. Physio may change the teams of payment at any tirne prior to delivery by providing written notice to the Purchaser. Physio reserves the right to charge a 1,5% restocking tee for returns. Unless otherwise indicated' document, delivery shall be FOB Physio point of shipment and title and risk of loss shall pass to the Purchaser at that point. Partial deliveries may be tie end partial invoices shall,lz; p;5 rrnitted and shall become due in accordance with the payment terms. In the absence of shipping instructions frorn the' Ph i) will obtain transportation on the Purchaser's behalf and for the Purchasers account. Excess charges for expedited delivery are the responsibility of the Purchaser unless specifically waived by Physio. ARRANGEMENT FOR INSURANCE OF MERCHANDISE IS THE RESPONSIBILITY OF THE PURCHASER. S. Delays Delivery dates are approximate Physio will not be liable for any loss or damage of any kind due to delays in delivery or non delivery resulting from any cause beyond its reasonable control, including but not limited to, acts of God, labor disputes, the requirements of any governmenta'; authority, war, civil unrest delays in manufacture, obtaining any required license or permit, and Physio inability to obtain goods from its usual sources. Any such delay shall not be considered a breach of Physio and the Purchaser's agreement and the delivery dales shall be extended for the length of such delay. 6. Inspection and Acceptance Claims by the Purchaser for damage to or shortages of goods delivered shall be made within thirty (30) days after shipment by providing Physio with written notice of any deficiency. In the absence of such notice. Physio will deem products and services accepted by Purchaser. Payment is not contingent upon irnmediate correction of any deficiencies and Physio prior approval is required before the return of any goods to Physio. 7. Warranty Physio warrants its products in accordance with the terms of the standard Physio product warranty applicable to the product to be supplied. and the remedies provided under such warranty shall be the Purchaser's sole and exclusive remedies. The warranties set forth therein are conditioned upon the proper use and maintenance and conformance with any applicable recommendations of Physio and upon Purchaser promptly notifying Physic of any defects. Phvsio makes no other warranties, express or implied, including, without limitation NO WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE AND IN NO EVENT SHALL PHYSiO BE LIABLE FOR INCIDENTAL, CONSEQUENTIAL, SPECIAL OR OTHFR DAMAGES. 8. Non- Warranty Service Non Warranty service is available by contacting a district office or the headquarters of Physic. All risk of loss, damage, freight and other costs for shipment to and from the point of repair shall be the responsibility of the Purchaser. 9, Patent Indemnity Upon receipt of prompt notice from the Purchaser and with the Purchaser's authority and assistance, Physio agrees to defend, indemnify and hold the Purchaser harmless against any claim that the Physio products covered by this document directly infringe any duly issued United States of America patent- 110. Third Party Liability Physio shall not be liable for arid Purchaser shall hold Physio harmless from any liability sustained in favor of third parties arising from or during Purchaser's possession, use or sale of Physio equipment except to the extent that such liability arises solely from Physic's negligence. Physio shall not be liable for and Purchaser shall hold Physio harmless from any liability for consequential damages sustained by Purchaser including those arising from or measured by lost profits under its contracts with third parties. 11. Miscellaneous a) The Purchaser agrees that products purchased hereunder will not be reshipped or resold to any persons or places prohibited by the laws of the United States of America b) Through the purchase of Physio products, the Purchaser does not acquire any interest in any tooling, drawings, design information, computer programming, patents or copyrighted or confidential information related to said products and the Purchaser expressly agrees not to reverse engineer or decompile such products or related software and information. ci Physio shall have the right to cancel or suspend this Agreement at any time upon Purchaser making an assignment for the benefit of creditors or becoming bankrupt or insolvent, or upon a petition being tiled in a court of competent jurisdiction proposing the appointment of a receiver or that Purchaser is adjudicated bankrupt or insolvent or reorganized under the provisions of any applicable bankruptcy or insolvency law. d) In addition to the rights and remedies reserved herein, Physic shall have all the rights and remedies conferred by law and shall not be required to proceed with performance of the contract arising hereirom if Purchaser is in default to Physio under this or any contract. e) The rights and obligations of Physio and the Purchaser related to the purchase and sale of products and services described in this document shall be governed by the laws of the State of Washington, United States of America. All costs and expenses incurred by Physio related to enforcement of its rights under this document, including reasonable attorney's fees, shall be reimbursed by the Purchaser. f.')2D07 Physio- Can €rol, Inc., a division of Medtronic. MIN 3201819-00 I CAT 26500 0027 09 Page: 3 Service Report Billing l Ph Control, Inc NVOICE I Mafl payments orrfy to this address 121. C ouecti trris ce n #er_f]r�ve 411019698 Formerly Medtronic ERS Ghlca o fL 6b$9" 11811 Willows Road NE g Post Office Box 97006 E Pfeese r #erer�ce lntrsrice Number. an yai r cheek 11/03/10 Redmond, WA 98073 -9706 USA I or "aU rl a Gall jolt ifoo" 1 800 92� 8047 Telephone: 425 -867 -4000 Fax: 425 -881 -2405 F.E.I.N. 91- 0697691 BILL TO ACCOUNT: 10774201 SHIP TO ACCOUNT: 10774201 Sold To: 10774201 CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 UNITED STATES UNITED STATES Please return top portion with payment. 'DATE "SHI ?PLU' YUF:CriP. 3c:vI3 D£R IJvft1B:R S.4LCS /SERL'iCi: REPRESENTATIVE 11/03/10 Mark Hulett EALL71 McWillia 003120155002/mj CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS GRD R6045912 -00 Net 30 Days i:;R :<17� ?��i':;:: :i :;Q F:ifi�$� .�.�.k�•`1�41:1�.�r:.. �ii`i` (�`i <:i >E <:ia �s:.: Cu...._ w CONTRACT Regular Labor 0.8 0.00 0.00 9 99400 0;001651: LP12:, EN, P; SP0;2 12 "L; T E FX,AED,B,NIBP,CO2,L S/N:13044135 3 r CONTRACT Regular Labor 0.7 0.00 0.00 I I 3 1'0. "994'IOl 0Q0618'' LIFE PAK 500 .AED, ::2;- Butlron.: Operation, ADAPTIV Biphasic S/N:31516823 CONTRACT Regular Labor 0.4 0.00 0.00 I� k1 994`01 '000390:: LZFEPAK: 500 AED, 2 Sutton T Operation, ADAPTTV �Biphasic S/N:13736716 CONTRACT Regular Labor 0.3 0.00 0.00 12 i 213.0 0 -.0 0 Z8 2 PAR T SALE j 3202674 -002 ELECT ASSY -EDGE QUIK 7.0 38.00 266.00 OVERHEAD Regular Labor 0.4 0.00 -3 J3 .000618 LIFEPAK 50.0 PED,. "2. But: on.. a Operation, ADAPTIV Biphasic S/N 31516759 CONTINUED ACCEPTED NOTE: TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN. I General Terms Physio- Control, Inc. ("Physio") acceptance of the Purchaser's order is expressly conditioned on the Purchaser's assent to the terms set forth in this document and its attachments. Physio agrees to furnish the goods and services ordered by the Purchaser only on these terms. and the Purchaser's acceptance of any portion of the goods and services covered by this document shall confirm their acceptance by the Purchaser. These terms constitute the complete agreement between the parties and they shall govern any conflicting or ambiguous terms on the Purchaser's Purchase order or on other clOCUmerlts submitted to Physio by the Purchaser. These terms may not be revised in any manner without the prior written consent of an officer of Physio. z. Pricing Unless otherwise indicates; in this document, prices of goods and services covered by this document shall be Physio standard }prices in effect at the time of delivery. Prices do not include freight insurance, freight forwarding fees, taxes, duties, import or export permit fees, or any other similar charge of any kind applicable to the goods and services covered by this document_ Sales or use taxes on domestic (USA) deliveries will be invoiced in addition to the price of the goods and services covered by this document unless Physio receives a copy of a valid exemption certificate prior to delivery. Please forward your tax exemption certificate to the Physio Tax Department R.O. Box 970013, Redmond Washington 98073 -9706 3. Payment Unless otherwise indicated in this document or otherwise confirmed by Physic in writing, payment for goods and services supplied by Physio shall be subject to the folloGving terms. Domestic {USA) Sales Upon approval of credit by Physio. 100" q of invoice due thirty €301 days after invoice date. International Sales Sight draft or acceptable (confirmed) irrevocable 1(3tter of credit. Physio may change the terms of payment at any time prior to delivery by providing written notice to the Purchaser. Physio reserves the right to charge a 157 restocking fee for returns. 4. Delivery Unless otherwise indicated in this document, delivery shall be FOB Physio point of shipment and title and risk of loss shall pass to the Purchaser at that point. Partial deliveries may be made and partial invoices shall be permitted and shall become due in accordance with the payment terms. In the absence of shipping instructions from the Purchaser Physio will obtain transportation on the Purchaser's behalf and for the Purchaser's account. Excess chamo5; for expedited delivery are the responsibility of the Purchaser unless specifically waived by Physic. ARRANGEMENT FOR INSURANCE OF MERCHANDISE IS THE RESPONSIBILITY OF THE PURCHASER. 5. Delays Delivery dates are approximate. Physio will not be liable for any loss or damage of any kind due to delays in delivery or non delivery resrilling from any cause beyond its reasonable control, including but not limited to, acts of Golf, labor disputes, the requirements of any governmental authority, war, civil unrest delays in manufacture, obtaining any required license or per €nit, and Physio inability to obtain goods from its usual sources. Any such delay shall not be considered a breach of Physic and the Purchaser's agreement and the delivery dates shall be extended for the length of such delay. 6. Inspection and Acceptance Claims by the Purchaser for damage to or shortages of goods delivered shall be made within thirty (30) days after shipment by providing Physio with written notice of any deficiency. In the absence of such notice. Physio will deem products and services accepted by Purchaser. Payment is not contingent upon i rnediate correction of any deficiencies and Physio prior approval is required before the return of any goods to Physio. 7. Warranty Physio warrants its products in accordance with the terms of the standard Physio product warranty applicable to the product to be supplied, and the remedies provided under such warranty shall be the Purchasers sole and exclusive remedies. The warranties set forth therein are conditioned upon the proper use and maintenance and conformance with any applicable recommendations of Physio and upon Purchaser promptly notifying Physio of any defects. Physio mhkes no other warranties, express or implied, including, without limitation, NO WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE AND IN NO EVENT SHALL PHYSIC BE LIABLE FOR INCIDENTAL, CONSEOUENTIAL. SPECIAL ON OTHER DAMAGES_ 8, Pion- Warranty Service Non Warranty service is available by contacting a district office or the headquarters of Physio. All risk of foss, damage, freight and other costs for shipment to and from the point of repair shall be the responsibility of the Purchaser, 9, Patent Indemnity Upon receipt of prompt notice from the Purchaser and with the Purchaser's authority and assistance, Physio agrees to defend, indemnify and hold the Purchaser harmless against any claim that the Physio products covered by this document directly infringe any duly issued United States of America patent. 10. Third Party Liability Physio shall not be liable for and Purchaser shall hold Physio harmless from any liability sustained in favor of third parties arising from or during P'urchaser's possession, use or sale of Physio equipment except to the extent that such liability arises solely from Physio's negligence. Physio "Shat not be liable for and Purchaser shall hold Physio Harmless from any liability for consequential damages sustained by Purchaser including those arising from or measured by lost profits under its contracts with third parties. 11. Miscellaneous a} The Purchaser agrees that products purchased hereunder will not be reshipped or resold to any persons or places prohibited by the laws of the United States of America. bj Through the purchase of Physio products, the Purchaser does not acquire any interest in any tooling, drawings, design information computer Programming. patents or copyrighted or confidential information related to said products and the Purchaser expressly agrees not to reverse engineer or decompile such products or related software and Information. cj Physio shall have the right to cancel or suspend this Agreement at any time upon Purchaser making an assignment for the benefit of creditors or becoming bankrupt or insolvent, or upon a petition being filed in a court of competent jurisdiction prnf7csing the appointrTrent of a receiver or that Purchaser is adjudicated bankrupt or insolvent or reorganized under the provisions of any applicable bankruptcy or insolvency iaWL d) In addition to the rights and remedies reserved herein, Physio shall have all the rights and remedies conferred by law and shall not be required to proceed with performance of the contract arising herefrom it Purchaser is in default to Physio under this or any contract. e) The rights and obligations of Physio and the Purchaser related to the purchase and sale of products and services described in this document shai) be governed by the laws of the State of Washington, United States of America. All costs and expenses incurred by Physio related to enforcement of its rights under this document, including reasonable attorney's fees, shall be reimbursed by the Purchaser. 02007 Physio- Conlrol, Inc., a division of Medtronic. MIN 3201819 -001 1 CAT 26500 002709 Page: 4 Physio- Control, Inc Service Report Billing ij INVOICE l l Ma�f, payments only to this address 13�a CnlleGtiiifts >ieriter Drive 41 01 }69$ Formerly Medtronic ERS Ghcagn fL G�1f393 11811 Willows Road NE Tease reterenae tnttt�l...... n @er On aiur cheGlt 1 1103/10 Post Office Box 97006 Redmond, WA 98073 -9706 USAOt ll2�tJr1?S F ell t01! #tEt' 8047 Telephone: 425- 867 -4000 Fax: 425- 881 -2405 F.E.I. N. 91- 0697691 BILL TO ACCOUNT: 10774201 SHIP TO ACCOUNT: 10774201 Sold To: 10774201 CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 UNITED STATES UNITED STATES Please return top portion with payment. ec:c a �:.:;;':F::;:............. _.'v: •'+:':5^:' DATE SHIP PED' PURCHASE ORDER NUNISER SALES!SERVICE REPRESENTAT 3A'ElkE� L �'U�3'Ii 11/03/10 Mark Hulett EALL71 McWillia 003120155002/mj f CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS GRD R6045912 00 Net 30 D ays 1r# N�...... v#' �Ls �I�i: F �Rlfr' th' �f.............................. #'t.�*.4i:31ti CONTRACT Regular Labor 0.4 0.00 0.00 1 .1:. 0390.? LIFEPAK ,500 AED, :2:Button Operation, ADAPTIV 3 !Biphasic a CONTRACT Regular Labor S /N: 13736714 0.4 0.00 0.00 15 9.9401. ':000618!; LIFE:PAK 500::PED, 2' Britton `Operation, ADAPTIV Biphasic j S/N:31516802 >ss CONTRACT Regular Labor 0.4 0.00 0.00 16,99401 00039.0 >ILIF PAK 500..AED 2 Button Operation, ADAPTIV B ipha s i c ?i3 S/N:13736710 CONTRACT Regular Labor 0.1 0.00 0.0.0. 17�99401.000390!�LIFEPAK:500 AED. 2.- Button Operation, ADAPTIV Biphasic S/N:13736715 CONTRACT Regular Labor 0.1 0.00 0.00 '18150999.000001s TRAVEL 1 CONTINUED M COMMMM ACCEPTED NOTE: TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN. 1. General Terms Physio-Control, Inc. "Physic acceptance of the Purchaser's order is expressly conditioned on the Purchaser's assent to the terms set forth in this document and its attachments. Physio agrees to furnish the goods and services ordered by the Purchaser only on these terms, and the Purchaser's acceptance of any portion at the goods and services covered by this document shall confirm their acceptance by the Purchaser. These terms constitute the complete agreement between the parties and they shall govern any conflicting or ambiguous terms on the Purchaser's Purchase order or on other documents Submitted to Physic by the Purchaser, These terms may not be revised in any mariner without the prior written consent of an officer of Phvsio. 2. Pricing Unless otherwise indicated in this document, prices of goods and services covered by this document shall be Physic standard prices in effect at the time of delivery. Prices'do not include freight insurance, freight forwarding fees, taxes, duties, import or export permit fees, or any other similar charge of any kind applicable to the goods and services covered by this document, Sales c,r use taxes on domestic (USA) deliveries will be invoiced in addition to the price of the goods and services covered by this document unless Physic receives a copy of a valid exemption certificate prior to delivery. Please forward your tax exemption certificate to the Physic Tax Department P,O. Box 97006, Redmond, Washington 3807:3 -9706 3. Payment Unless otherwise indicated in this document or otherwise confirmed by Physic in writing payment for goods and services supplied by Physio shall be subject to the following',erms: Domestic (USA) Sales Upon approval of credit by Physic. 100AO of invoice due thirty (30) days after invoice date. International Safes Sight draft or acceptable (confirmed) irrevocable letter of credit. Physio may change the terms of payment at any time prior to delivery by providing written notice to the Purchaser. Physio reserves the right to charoe a 15`�' restocking fee for returns. 4. Delivery Unless otherwise indicated in this docurent, delivery shall be FOB Physio point of shipment and title and risk of loss shall pass to the Purchaser at that point. Partiaf deliveries may be made and partial invoices shall be permitted and shall become due in accordance with the payment terms. lrn the :absence of shipping instructions from the Purchaser, Physic will obtain transportation on the Purchasers behalf and for the Purchaser's account. Excess charges for expedited delivery are the responsibility of the Purchaser unless specifically waived by Physio, ARRANGEMENT FOR INSURANCE OF MERCHANDISE IS THE RESPONSIBILITY OF THE PURCHASER. 6. Delays Delivery dates are approximate. Physic will not be liable for any loss or damage of any kind due to delays in delivery or non delivery resulting from any cause beyond its reasonable control, including but not Limited to. acts of God, labor disputes, the requirements of any governmental authority, •war, civil unrest delays In manufacture obtaining any required license or permit, and Physic inability to obtain goods from its usual sources. Any such delay shall not be considered a breach of Physio and the Purchaser's agreement and the delivery dates shall be extended for the length of such delay. 6- Inspection and Acceptance Claims by the Purchaser for damage to or shortages of goods delivered shall be made within thirty (30) days after shipment by providing Physio with written notice at any deficiency. In the absence of such notice, Physio will deem products and services accepted by Purchaser. Payment is not contingent upon immediate correction of any deficiencies and Physio prior approval is required before the return of any goods to Physio 7. Warranty Physio warrants its products in accordance with the terms of the standard Physio product warranty applicable to the product to he supplied, and the remedies provided under such warranty shall be the Purchaser's sole and exclusive remedies. The warranties set forth therein are conditioned upon the proper use and maintenance and conformance with any applicable recommendations of Physio and upon Purchaser promptly notifying Physio of any defects. Physio makes no other warranties, express or implied, including, without limitation, NO WARRANTY OF MERCHANT ABILITY OR FITNESS FOR A PARTICULAR PURPOSE AND IN NO EVENT SHALL, PRYSIO BE LIABLE FOR INCIDENTAL. CONSEQUENTIAL SPECIAL OR OTHER DAMAGES, 8, Non Warranty Service Non Warranty service is available by contacting a district office or the headquarters of Physio. Ail risk of loss. damage, freight and other costs for shipment to and from the point of repair shall be the responsibility of the Purchaser. 9. Patent Indemnity Upon receipt of prompt notice from the Purchaser and with the Purchaser's authority and assistance, Physio agrees to defend, indemnify and hold the Purchaser harmless against any claim that the Physio products covered by this document directly infringe any duly issued United States of America patent. 10. Third Party Liability Physio shall not be liable for and Purchaser shah; hold Physio harmless from anV liability sustained in favor of third parties arising from or during Purchaser's possession, use or sale of Physio equipment except to the extent that such liability arises solely from Physio's negligence. Physio shall not be liable for and Purchaser shall hold Physio harmless from any liability for consequential darnages sustained by Purchaser including those arising from or measured by lost profits under its contracts with third parties. 11. Miscellaneous a? The Purchaser agrees that products purchased hereunder will not be reshipped or resold to any persons or places prohibited by the laws of the United States of America. b? Throu gh the purchase of Physio products. the Purchaser does not acquire any interest in any tooling, drawings, design information, computer programming, patents or copyrighted or confidential information related to said products and the Purchaser expressly agrees not to reverse engineer or decompiie such products or related software and information. cl Physio shall have the right to cancel or suspend this Agreement at any time upon Purchaser making an assignment for the benefit of creditors or becoming bankrupt or insolvent,_ or upon a petition being filed in a court of competent jurisdiction proposing the appointn'rent of a receiver or that Purchaser is adjudicated bankrupt or insolvent or reorganized under the provisions of any applicable bankruptcy er insolvency law. di In addition to the rights and remedi reserved herein, Physic shall have all the rights and remedies conterred by lave and shalf not be required to proceed with performance of the contract arising herefrom if Purchaser is in default to Physio under this or any contract. el The rights and obligations of Physio and the Purchaser related to the purchase and sale of products and services described in this document shall be governed by the laws at the State of Washington United States of America. All costs and expenses incurred by Physio related to enforcement of its rights under this document, including reasonable attorney's fees, shall be reimbursed by the Purchaser- Cc 2007 Physic- Cori'trol, Inc a division of Medtronic. MIN 3201819 -001 I CAT 26500 002709 Page: 5 Physio- Control, Inc Service Report Billing INVOICE Matt payrrlents only to this address 1'2ti30 Cp llectlbds Cer}te� Dave 411019698 Formerly Medtronic ERS Chita o :I'L 80593 11811 Willows Road NE g Post Office Box 97006 f .I eAst reference hvOlde, tutrlber otl your check 11/03/10 Redmond WA 98073-9706 USA Ft�# Iltquirles Gall roll #ree 1 8013 -42$ 8047 Telephone: 425-867-4000 '.u._, Fax: 425 -881 -2405 F.E.I.N, 91- 0697691 BILL TO ACCOUNT: 10774201 SHIP TO ACCOUNT: 10774201 Sold To: 10774201 CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 UNITED STATES UNITED STATES Please return top portion with payment. P URCH A SE R .DE SALES/S -,e F sr!: :.iF2:.iFw` }Y '�'C: SF SRIYYgl7 �[3£�i Wl�f��ucR aEPn�5_u `i 01 ;:•;;.::....,d..Y....1 11/03/10 Mark Hulett EALL71 McWillia 00312-9 5002/mj I CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS ......GRD R6045912 T O0 Net .3 Days...:- :a::.:: �:.�Nf�: ���j t# i? kf' i ':::P..ftl��:::� >�t'I ::11 11~�i.tl,�l��R :;:E�t�3if�ibfi�t w CONTRACT FRegular Travel 2.2 0.00 0.00 I Sub Total 266.00 REF S /R: R6045912 DATE COMP: 11/03/10 CONTRACT: PB11Y043 l :3 266.00 Site: 20 O R I G I N A L v 1 ACCEPTED NOME: TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN. 1. General Terms Physio- Control, Inc. ("Physic") acceptance of the Purchaser's order is expressly conditioned on the Purchasers assent to the terms set forth in this document and Its attachments. Physio agrees to furnish the goods and services ordered by the Purchaser only on these terns, and the Purchaser's acceptance of any portion of the goods and services covered by this document shall confirm their acceptance by the Purchaser. These terms constitute the complete agreement between the parties and they shall govern any conflicting or ambiguous terms on the Purchaser's Purchase order or on other documents submitted to Physio by the Purchaser. These terrns may not be revised in any manner without the prior written consent of an officer of Phvsio. 2. Pricing Unless otherwise indicated in this document, prices of goods and services covered by th docurnent shall be Physio standard prices in effect at the time of delivery. Prices do not include freight insurance, freight forwarding fees, taxes, duties import or export permit fees, or any other similar charge of any kind applicable to the goods and services covered by this document. Sales or use taxes on domestic (USA) deliveries will be invoiced in addition to the price of the goods and services covered by this document unless Physio receives a copy of a valid exemption certificate prior to delivery. Please forward your tax exemption certificate to the Physio Tax Department P.O. Box 97006, Redmond, Washington 98073 -9706 3. Payment Unless otherwise indicated in this document or otherwise confirmed by Physio in writing, payment for goods and services supplied by Physio shall be subject to the following terms: Domestic (USA) Sales Upon approval of credit by Physic. 100 of invoice due thirty (30) days after invoice date. International Sales Sight draft or acceptable (confirmed) irrevocable letter of credit. P:.�vsio may change the terms of payment at any time prior to delivery by providing written, notice to the Purchaser. Physic reserves the right to charge a 1 59 restocking fee for returns. 4. Delivery Unless otherwise indicated in this document, delivery shall be FOES Physio point of shipment and title and risk of loss shall pass to the Purchaser at that poini:. Partial deliveries may be made and partial invoices shall be permitted and shall become due in accordance with the payment terms. In the absence of shipping instructions from the Purchaser, Physio will obtain transportation on the Purchaser's behalf and for the Purchaser's account. Excess charges for expedited delivery are the responsibility of the Purchaser unless specifically waived by Physio. ARRANGEMENT FOR INSURANCE OF MERCHANDISE IS THE RESPONSIBILITY OF THE PURCHASER. 5, Delays Delivery dates are approxirrsats. Physio will not be liable for any loss or damage of any kind due to delays in delivery or non- delivery resulting from any cause beyond its reasonable control, including but not limited to, acts of God, labor disputes, the requirements of any governmental authority, war, civil unrest delays in manufacture, obtaining any required license or permit, and Physio inability to obtain goods from its usual sources. Any such delay shall not be considered a breach of Physio and the Purchaser's agreement and the delivery dates shall be extended for the length of such delay. 6. Inspection and Acceptance Claims by the Purchaser for damage to or shortages of goods delivered shall be made within thirty (30) days after shipment by providing Physio with written notice of any deficiency. In the absence of such notice. Physio will deem products and services accepted by Purchaser. Payrr €ent is not contingent upon immediate correction of any deficiencies and Physio prior approval is required before the return of any goods to Physio. 7. Warranty Physio warrants its products in accordance with the terms of the standard Physic product warranty applicable to the product to be supplied, and the remedies provided under such warranty shall be the Purchaser's sole and exclusive remedies. The warranties set forth therein are conditioned upon the proper use and maintenance and conformance with any applicable recommendations of Physio and upon Purchaser promptly notifying Physio of any defects. Physic makes no other warranties express or implied, including without limitation, NO WARHANTY OF MERCHAN (ABILITY OR FI I NESS FOR A PAR T iCULAR PURPOSE AND IN NO EVENT SHALL PHYSIC; BE LIABLE. FOR INCIDENTAL CONSEQUENTIAL. SPECIAL OR OTHER DAMAGES. 8, Non- warranty Service Nan Warranty services available by contacting a district office or the headquarters of Physio. All risk of loss, darnage, freighl and other cos *.s for shipment to and from the point of repair shalt be the responsibility of the Purchaser. 9, Patent Indemnity Upon receipt of prompt notice from the Purchaser and with the Purchaser's authority and assistance, Physio agrees to defend. indemnity and hold the Purchaser harmless against any claim that the Physio products covered by this document directly infringe any dryly issuers United States of Arnerica patent. 10. Third Party Liability Physio shall not be liable for and Purchaser shall hold Physio harmless from any liability sustained in favor of third parties arising frorn or during Purchasers possession, use or sale of Physio equipment except to the extent that such liability arises solely from Physio's negligence. Physio shall not be liable for and Purchaser shall hold Physio harmless from any liability for consequential darnages sustained by Purchaser i,icluding those arising from or measured by lost profits under its contracts with third parties. 11. Miscellaneous a The Purchaser agrees that products purchased hereunder will not be reshipped or resold to any persons or places prohibited by the laws of the United States of America. b) Through the purchase of Physio products, the Purchaser does not acquire any interest in any tooling, drawings, design information, computer programming, patents or copyrighted or confidential information related to said products and the Purchaser expressly acirees not to reverse engineer or decompile such products or related software and information. c) Phvsio shall have the right to cancel or suspend this Agreement at any time upon Purchaser making an assignment for the benefit of creditors or becoming bankrupt or insolvent, or upon a petition being filed in a court of competent jurisdiction proposing the appointment of a receiver or that Purchaser is adjudicated bankrupt or insolvent or reorganized under the provisions of any applicable bankruptcy or insolvency law. di In addition to the rights and remedies reserved herein, Physic shall have all the rights and remedies conferred by law and shall not be required to proceed with performance of the contract arising herefrom if Purchaser is in default to Physio under this or any contract. e) The rights and obligations of Physio and the Purchaser related to the purchase and sale of products and services described in this document shslf be governed by the laws of the Slate of Washington, United States of America. All costs and expenses incurred by Physio related to enforcement of its rights tinder this document, including reasonable attorney's fees, shall be reimbursed by the Purchaser. `J2007 Plwsio Control. €r€c a division rat Medtronic. MIN 3201819 -003 I'At 26600- 002709 Page: 1 I Physic- Control, Inc Service Report Billing INVOICE Mai# payinenis azt ly to this address I 1:21Q0 Gollectlons Center Qrtve 411019640 Formerly Medtronic ERS ChGgga IL 6flS93 Posi Box 97006E t�lease rt #rerlCe InvslGe NumOe:r do ytr eltack 11/03/10 Redmond, WA 98073 -9706 USA Faf Il�lltll4S Gall tali :Iii 1 800�428 8047 Telephone: 425-867-4000 uu. u. .yam Fax: 425-881-2405 F.E.I.N. 91- 0697691 BILL TO ACCOUNT: 10774201 SHIP TO ACCOUNT: 10774201 Sold To: 10774201 CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 UNITED STATES UNITED STATES Pfe &Se return top portion with payment. r DATE SHIPPED PURCHASE ORDER SALES/SERVICE REPRESENTATIVE 1`�$ 11/03/10 Mark Hulett EALL72 Finnegan 00312 0 155002/mj CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS G R22 -00 Net 30 Days ........................#i#). Ohl€.::..:.:.:,:.,.:.. :.:.::..,.,:.:.:..:.:.::.:,.:#1 .ti :(1>b..... l;t3t... Q Y;C1:,:: El�t. a 99400003505;: LP12 DEFIB /MC7N, ADAPTIT BIPHASIC, AED, EL SCREEN, PACING, SP02, 12LEAD, FAX, NIBP, ETCO2 TRENDING, 100MM PRINTER S/N:36266689 CONTRACT Regular Labor 0.8 0.00 0.00 2 99400- 000347LP.12'�DEFIB /MOH, ADAPTTV I Biphasic, AED, EL Screen, Pacing, SPo2, 12Lead, Fax, NIBP, ETCo2, 100mm Printer S/N:30689228 CONTRACT Regular Labor 0.8 0.00 0.00 3 j 99400 1., 0;00165; LP12, EN.;:P, SP02, 12L, 100M, FX,AED,B,NIBP,CO2,L S/N:13044- i i CONTRACTS Regular Labor 0.8 0.00 0.00 ::::i 4 1 99100 fl00165`:LP12; DEF;IB /MOIL, ADAPTIU j fi (Biphasic, AED, LCD Screen, Pacing, SPo2, 12Lead, Fax, NIBP, ETCo2, 100mm Printer S/N:14210498 CONTINUED v ACCEPTED NOTE: TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN. 1. General Terms Physio Control, Inc. (•'Physio•';r acceptance of the Purchaser's order is expressly conditioned on the Purchaser's assent to the terms set forth in this document and its attactiments. Physic agrees to furnish the goods and services ordered by the Purchaser only on these terms, and the Purchaser's acceptance of any portion of the goods and services covered by this document shall confirm their acceptance by the Purchaser. These terms constitute the complete agreement between the parties and they shall govern any conflicting or ambiguous terms on the Purchasers Purchase order or on other documents submitted to Physio by the Purchaser. These terms may not be revised in any manner without the prior written consent of an officer of Physic. 2, Pricing Unless otherwise indicated in this document, prices of goods and services covered by this document shall be Physio standard prices in effect at the time of delivery. Prices do not include freight insurance, freight forwarding fees, taxes, duties import or export permit fees, or any other similar charge of any kind applicable to the goods and services covered by this document. Sales or use taxes on domestic (USA) deliveries will be invoiced in addition to the price of the goods and services covered by this document unless Physio receives a copy of a valid exemption certificate prior to delivery. Please forward your tax exemption certificate to the Physio (ax Department P.Q. Box 97006, Redmond, Washington 98073 -9706 3, Payment Unless otherwise indicated in this document or otherwise confirmed by Physic in writing, payment for goods and services supplied by Physio shall be subject to the following terms: Domestic (USA) Sales Upon approval of credit by Physio. 100`%a of invoice due thirty (3O) days after invoice date. International Sales Sight draft or acceptable (confirmed) irrevocable letter of credit. Physio may change the terms of payment at any time prior to delivery by providing written notice to the Ptlrcnaser. Physio reserves the right to charge a 15% restocking fee for returns. 4. Delivery Unless otherwise indicated in this document, delivery shall be FOB Physio point of shipment and title arid risk of loss shall pass to the Purchaser at that point. Partial deliveries may be made and partial invoices shall be permitted and shall become due in accordance with the payment terms. In the absence of shipping instructions from the Purchaser, Physio will obtain transportation on the Purchasers behalf and for the Purchaser's account. Excess charges for expedited delivery are the responsibility of the Purchaser unless specifically waived by Physio. ARRANGEMENT FOR INSURANCE OF MERCHANDISE IS THE RESPONSIBILITY OF THE PURCHASER. 5. Delays Delivery dates are approximate_ Physio will not be liable for any loss or damage of any kind due to delays in delivery or non delivery resulting from any cause beyond its reasonable control, including but not limited to, acts of God, labor disputes, the requirements of any governmental authority, war, civil unrest, delays in manufacture, obtaining any required license or permit, and Physio inability to obtain goods from its usual sources. Any such delay shall not be considered a breach of Physio and the Purchaser's agreement and the delivery dates shall be extended for the length of such delay. 6. Inspection and Acceptance Claims by the Purchaser for damage to or shortages of goods delivered shall be made within thirty (30) days after shipment by providing Physio with written notice of any deficiency. In the absence of such notice. Physio will deem products and services accepted by Purchaser. Payment is not contingent upon immediate correction of any deficiencies and Physio. prior approval is required before the return of any goods to Physio. 7. Warranty Physio warrants its products in accordance with the terms of the standard Physio product warranty applicable to the product to be supplied, and the remedies provided tinder such warranty shall be the Purchaser's sole and exclusive remedies. The warranties set forth ;herein are conditioned upon the proper use and maintenance and conformance with any applicable recommendations of Physio and upon Purchaser promptly notifying Physio of any detects. Physio makes no other warranties express or implied, including, without limitation. NO WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE AND IN NO EVENT SHALL PHYSIO BE LIABLE FOR INCIDENTAL CONSEQUENTIAL, SPECIAL OR OTHER DAMAGES, 8. Non- Warranty Service Non Warranty service is available by contacting a district office nr the headquarters of Physio, All risk of loss, damage, freight acid other costs for shipment to and from the point of repair shall be the responsibility of the Purchaser. 9. Patent Indemnity Upon receipt of prompt notice from the Purchaser and with the Purchaser's authority and assistance, Physio agrees to defend, indemnify and hold the Purchaser harmless against any claim that the Physio products covered by this document directly infringe any duly issued United States of America patent. 10. Third Party Liability Physto shall net be liable for and Purchaser shall hold Physic harmless from any liability sustained in favor of third parties arising from or during Purchaser's possession• use or sale of Physio equipment except to the extent that such liability arises solely from Physic's negligence. Physic shall not be liable for and Purchaser shall hold Physio harmless from any liability for consequential damages sustained by Purchaser including those arising from or measured by lost profits under its contracts with third parties. 11. Miscellaneous a) Purchaser agrees that products purchased hereunder will not be reshipped or resold to any persons or places prohibited by the laws of the United States of America. b) Through the purchase of Physio products, the Purchaser does not acquire any interest in any tooling, drawings, design information, computer programming, patents or copyrighted or confidential information related to said products and the Purchaser expressly agrees not to reverse engineer or decornpile such products or related software and information. c Physio shall have the right to cancel or suspend this Agreement at any time upon Purchaser making an assignment for the benefit of creditors. or becoming bankrupt or insolvent, or upon a petition being filed in a court of competent jurisdiction proposing the appointment of a receiver or that Purchaser is adjudicated bankrupt or insolvent or reorganized undef the provisions of any applicable bankruptcy or insolvency law. d) In addition to the rights and remedies reserved herein. Physio shall have all the rights and remedies conferred by law and shall not be required to proceed wiln performance of the contract arising herefrom if Purchaser is in default to Physio under this or any contract. e) The rights and obligations of Physio and the Purchaser related to the purchase and sale of products arid services described in this document shall he governed by the laws of the State of Washington, United States of Arnerica_ All costs and expenses incurred by Physio related to entorcerrrent of its rights under this document, including reasonable attorney's fees, shall be reimbursed by the Purchaser. CO2007 Physic Control, inc., a divis €on of Medtronic. MIN 3201819 -001 /CA'T' 26500- 002709 Page: 2 Service Report Billing 1 Physio- Control, Inc 1 INVOICE Mast payments only to this address I 72IOQ Collectlotts Cer}ter Drove 411019640 Formerly Medtronic ERS ChIcaga �L Bi69 11811 Willows Road NE #'lease referena:lnvolce;Number nt>< atr cltack 11 /03 /10 Post Office Box 97006 Redmond, WA 98073 -9706 USA Far Inqulroesa11 toll free 1 800 8b4 Telephone: 425- 867 -4000 L Fax: 425 881 -2405 F.E.I.N. 91- 069769 BILL TO ACCOUNT: 10774201 SHIP TO ACCOUNT: 10774201 Sold To: 10774201 CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 UNITED STATES UNITED STATES Please return top portion with payment. DATE SHIPPED iU iCRASE ORptR NUMBER SALESlSERVICE REPRESENTATIVE mmi':ii x 11/03/10 Mark Hulett i EALL72 Finnegan 0031 Y 5 02 /mj CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS I_ GRD R2290630 -00 Ne 30 D ays xxt ..[t;....... �i. �x. t�# �1� ...................#a�#.tll?'4' Its.._..._................. ....................�17�*..��_. �t�..... u. F3P.....f2•#".YY`..�lQ::::..,:. IEEE' �1��::..::. 1�3�'�:1•`.�.:.:............... CONTRACT Regular Labor 0.8 0.00 0.00 s k IBIPHASIC, AED, EL SCREEN, PACING, SP02, 12LEAD, FAX, NIBP, ETCO2, TRENDING, 100MM PRINTER s S/N:36266691 CONTRACT Regular Labor 0.8 0.00 0.00 6 994:00- 0.00165LP12 DEFTB /MON, ADAPTIV tI+ Biphasic, AED, LCD Screen, Pacing, SP02, 3 12Lead, Fax, NIBP, ETCo2, i 100mm Printer S/N:14210497 CONTRACT Regular Labor 0.8 0.00 0.00 7 99400 000821= LP12; DEFIB /MON, ADAPTIV I3iphasic, AED, EL Screen, Pacing, SPo2, 12Lead, Fax, NIBP, ETCo2, Trending, 100mm Printer S N 31516 3 91 CONTRACT Regular Labor 0.8 0.00 0.00 :8 T 99400 00'016.5 LP1-2 EN;,.P; SPO2, 12L, 100M, I CONTINUED V ACCEPTED NOTE: TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN. 1. General Terms Physio- Control, Inc. "Physio') acceptance of the Purchaser's order is expressly conditioned on the Purchaser's assent to the terms set forth In this document and its attachments. Physio agrees to furnish the goods and services ordered by the Purchaser only on these terms, and the Purchasers acceptance of any portion of Inc goods and services covered by this document shall confirm their acceptance by the Purchaser. These terms constitute the complete agreement between the parties and they shall govern any conflicting or ambiguous terms on the Purchaser's Purchase order or on other documents submitted to Physic by the Purchaser. These terms may not be revised in any manner without the prior written consent of an officer of Physic. 2. Pricing Unless otherwise indicated in this document, prices of goods and services covered by this document shall be Physio standard prices in eftect at the time of delivery, Prices do not indude freigl it insurance, freight forwarding fees, taxes, duties, import or export permit fees, or any other similar charge of any kind applicable to the goods and services covered by this document. Sales or use taxes on domestic (USA) deliveries will be invoiced in addition to the price of the goods and services covered by this document unless Physio receives a copy of a valid exemption certificate prior to delivery. Please forward Your tax exemption certificate to the Physio Tax Department P.O. Box 97006, Redmond, Washington 98073 -9706 3. Payment Unless otherwise indicated in this document or otherwise confirmed by Physio in writing, payment for goods and services supplied by Physio shall be subject to the following terms: Domestic (USA) Sales Upon approval of credit by Physio. 100% of invoice due thirty (30) days after invoice date. international Sales Sight draft or acceptable (confirmed) irrevocable letter of credit_ Physio may change the terms of payment at any time prior to delivery by providing written notice to the Purchaser, Physio reserves the right to charge a aestocking fee for returns. 4, Delivery Unless otherwise indicated in this document, delivery shall be FOB Physic. point of shipment and title and risk of loss shall pass to the Purchaser at that point. Partial deliveries may be made and partial invoices shall be permitted and shall become due in accordance with the payment terms. In the absence of slipping instructions from the Purchaser Physio will obtain transportation or. the Purchaser's behalf and for the Purchaser's account. Excess charges for expedited delivery are the responsibility of the Purchaser unless specifically waived by Physio. ARRANGEMENT FOR INSURANCE OF MERCHANDISE IS THE RESPONSIBILITY OF THE PURCHASER. 5. [delays Detivery dates are approximate. Physio will not be liable for any loss or damage of any kind due to delays in delivery or non- delive y resulting from any cause beyond its reasonable control, including but not limited to, acts of God, labor disputes, the requirements of any governmental authority, war, civi4 unrest, delays in rnanufactUre, obtaining any required license or per €nit, and Physio inability to obtain goods from its usual sources. Any such delay shall not be considered a breach of Physio and the Purchaser's agreement and the delivery dates shall be extended for the length of such delay. 6. Inspection and Acceptance Claims by the Purchaser for damage to or shortages of goods delivered shall be made within thirty (30) days after shipment by providing Physio with written notice of any deficiency. In the absence of such notice, Physio will deem products and services accepted by Purchaser. Payment is not contingent upon immediate correction of any deficiencies and Physio prior approval is required before the return of any goods to Physio. 7, Warranty Physio warrants its products in accordance with the terms of the standard Physio product warranty applicable to the product to be supplied, and the remedies provided under such warranty shall be the Purchasers sole and exclusive remedies. The warranties set forth therein are conditioned upon the proper use and maintenance and conformance with any applicable recommendations of Physio and upon Purchaser promptly notifying Physio of any defects. Physic makes no other warranties, express or implied, including, without limitation, NO WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE AND IN NO EVENT SHALL PHYSIC) BE LIABLE FOR INCIDENTAL, CONSEQUENTIAL SPECIAL OR 031-IER DAMAGES, 8. Non Warranty Service Non- Warrarity service is available by contacting a district office or the headquarters of Physio. All risk of loss, damage, freight and other costs for shipment to and from the point of repair shall be the responsibility of the Prrrchaser. 9. Patent Indemnity Upon receipt of prompt notice from the Purchaser and with the Purchaser's authority and assistance, Physio agrees to defend. indemnify and hold the Purchaser harmless against anv claim that the Physio products covered by this document directly infringe any duly issued United States of America patent. 10. Third Party Liability Physio shaft not be liable for and Prrrchaser shall hold Physio harmless from any liability sustained in favor of third parties arising from or during Purchaser's possession, use or sale of Physio erruipment except to the extent that such liability arises solely from Physics negligence_ Physio shall not be liable for and Purchaser shall hold Physio hammless from any liability for consequential damages sustained by Purchaser including those arising from or measured by lost profits under its contracts with third parties. 11. Miscellaneous a) the Purchaser agrees that products purchased hereunder will not be reshipped or resold to any persons or places prohibited by the laws of the United States of America. b) Through the purchase of Physio products, the Purchaser does not acquire any interest in any tooling, drawings, design information, computer programming, patents or copyrighted or confidential information related to said products and the Purchaser expressly agrees riot to reverse engineer or decompile such products ar related software and information. cl Physio shall have the right to cancel or suspend this Agreement at any time upon Purchaser making an assignment for the benefit of creditors or becoming bankrupt or insolvent. or upon a petition being filed in a court of competent jurisdiction proposing the appointment of a receiver or that Purchaser is adjudicated bankrupt or insolvent or reorganized under the provisions of any applicable bankruptcy or Insolvency law. d) In addition to the rights and remedies reserved herein, Physio shall have all the rights and remedies conferred by law and shall not be required to proceed with performance of the contract arising herefrom if Purchaser is in default to Physio under this or any contract. e) The rights and obligations of Physio and the Purchaser related to the purchase and sale of products and services described in this document shall be governed by the laws of the State of Washington, United States of America. All costs and expenses incurred by Physio related to enforcement of its rights under this document. including reasonable attorney's fees, shall be reimbursed by the Purchaser. J2007 Prysio- Co €ltrol, Inc, a division of Medtronic. MIN 3201819-001 1 CAT, 265 00 002709 Service Report Billing I #�hysia- Control, Inc INVOICE Page: 3 Nl01_ Paymenfs 0111 V 0 this address 12100 Colte CtlLlYts Center Qrlve 411019640 Formerly Medtronic ERS ChiGaga X0693 11811 Willows Road NE I 1ple a reference. nvolaeo Urn on yi ur check 1 1103/10 Post Office Box 97006 Redmond, WA 98073 -9706 USA Ing UITIE5 Call tol(f fry 1 80© -426 8047 Telephone: 425- 867 -4000 Fax: 425 881 -2405 F.E.I.N. 91- 0697691 BILL TO ACCOUNT: 1 10774201 SHIP TO ACCOUNT: 10774201 Sold To: 10774201 CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 UNTIED STATES UNITED STATES Please return top portion with payment. ""'rte "MATE SHiPPe HASE ORDER NUMBER 5AtESlEtRVICE REPRESENTATIVE a7,.(�h!!P'. 111/03/10 Mark Hulett EALL72 Finnegan 003120155002/mj CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS GRD R2290630 -00 Net 30 Days 0:• ?'.SHI� FX,AED,B,NIBP,CO2,L S/N:12984818 1 CONTRACT Regular Labor 0.8 0.00 0.00 9 9A 00390, hIFEPAK 500 AED, 2 Button Operation, ADAPTIV Biphasic S/N:13736711 CONTRACT Regular Labor 0.5 0.00 0.00 10. 99401 ..0.00618': LIFEPAK 500. AED, 2' .Button I T I Operation, ADAPTIV Biphasic S/N:31516775 CONTRACT :ON..,..DEVTCE::::SERV10E egular Labor 0.5 0.00 0.00 ><`<i1 1>l ACTIVITY _3 20823 1 -0_0_0 IKIT -LISO2 BATTERY RE 2.0 0.00 0.00 CONTRACT Regular Labor 1.0 0.00 0.00 1'2 21300 002827: PART: SAI; 3009086 -006 DEG -4 CABLE EXTENSIO 1.0 50.00 50.00 i OVERHEAD Regular Labor 0.2 0.00 0.00 a 50999 0 TRAVEL CONTRACT Regular Travel 0.7 0.00 0.00 CONTINUED v ACCEPTED NOTE: TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN. 1. General Terms Physio- Control, Inc. ("Physic") acceptance of the Purchasers order is expressly conditioned on the Purchasers assent to the terms set forth in this document and its attachments. Physic agrees to furnish the goods and services ordered by the Purchaser only on these terms. and the Purchaser's acceptance of any portion of the goods and services covered by this document shall confirm their acceptance by the Purchaser. These terms constitute the complete agreement between the parties and they shall govern any conflicting or arnbiguous terms on the Purchaser's Purchase order or on other documents submitted to Physic by the Purchaser. These terms may not be revised in any manner without the prior written consent of an officer of Physic. 2. Pricing Unless otherwise indicated in this document, prices of goods and services covered by this document shall be Physic standard prices in effect at the time of del €very. Prices do not include freight insurance, freight forwarding tees, taxes, duties, import or export permit fees, or any other similar charge of any kind applicable to the goods and services covered by this document. Sales or use taxes on domestic (USA) deliveries will be invoiced in addition to the price of the goods and services covered by this document unless Physic receives a copy of a valid exemption certificate prior to delivery, Pease forward your tax exemption certificate to the Physic Tax Department P.O. Box 97006, Redmond Washington 98073-9706 3. Payment Unless otherwise indicated in this document or otherwise confirmed by Physic in writing, payment: for goods and services supplied by Physic shall be subject to the following terms. Domestic. (USA) Sales Upon approval of credit by Physio. 100 °0 of invoice due thirty (3D) days after invoice date. International Sales Sight draft or acceptable (confirmed) irrevocable letter of credit. Physio may change the terms of payment at any time prior to delivery by providing written notice to the Purchaser. Physio reserves the right to charge a ;5 restocking tee for returns. A. Delivery Uriless otlierwise indicated in this document, delivery shall be FOB Physic point of shipment and title and risk of loss shall pass to the Purchaser at that point. Partial deliveries may be made and partial invoices shall be permitted and shall become due in accordance with the payment terms. In the absence of shipping instructions from the Purchaser, Physio will obtain transportation an the Purchaser's behalf and for the Purchaser's account. Excess charges for expedited delivery are the responsibility of the Purchaser unless specifically waived by Physio. ARRANGEMENT FOR INSURANCE OF MERCHAND)SE IS THE AESPONSIBiLITY OF THE PURCHASER 5. Delays Delivery dales are approximate-. Physio will not be liable for any loss or damage of any kind due to delays in delivery or non- delivery rostaiting from any cause beyond its reasonable control, including but not limited to, acts of God, labor disputes, the requirements of any govemmentai authority, wc rr, civil unrest, delays in manufacture obtaining any required license or permit, and Physio inability to obtain goods from its usual sources. Any such delay shall not be considered a breach of Physio and the Purchaser's agreement and the delivery dates shall be extended for the length of such delay. 6. Inspection and Acceptance Claims by the Purchaser for damage to or shortages of goods delivered shall be made within thirty (30) days after shipment by providing Physio with written notice of any deficiency. In the absence of such notice, Physio will deem products and services accepted by Purchaser. Payment is not contingent upon immediate correction of any deficiencies and Physio prior approval is required before the return of any goods to Physio. 7. Warranty Physio warrants its products in accordance 'with the terms of the standard Physio product warranty applicable to the product to be supplied, and the remedies provided under such warranty shall be the Purchasers sole and exclusive remedies. The warranties set forth therein are conditioned upon the proper use and maintenance and conformance with any applicable recommendations of Physio and upon Purchaser promptly notifying Physics of any defects. Physio makes no other warranties, express or implied, including, without limitation, NO WARRANTY OF MEHCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE AND IN NO EVENT SHALL PHYSIO BE LIABLE FOR INCIDENTAL, CONSEQUENTIAL. SPECIAL OR 01 HER DAMAGES, 8. Non Warranty Service Non Warranty service is available by contacting a district office or the headquarters of Physio. All risk of loss, damage, freight and other costs for shipment to and from the point of repair shall be the responsibility of the Purchaser. 9, Patent Indemnity Upon receipt of prompt notice from the Purchaser and with the Purchase!'s authority and assistance, Physio agrees to defend, indemnity and hold the Purchaser harmless against any claim that the Physio products covered by this document directly infringe any duly issued United States of America patent. 10. Thirst Party Liability Physio shalt aicl be liabie for and Purchaser shall hold Physio harmless from any liability sustained in favor of third parties arising from or during Purchaser's possessicn, use or sale of Physic equipment except to the extent that such liability arises solely from Physio's negligence. Physio shall not be liable for and Purchaser shall hold Physio harmless from any liability for consequential damages sustained by Purchaser including those arising from or measured by lost profits under its contracts with third parties. 11. Miscellaneous a) The Purchaser agrees that products purchased hereunder will not be reshipped or resold to any persons or places prohibited by the laws of the United States of America. b) Through the purchase of Physio products, the Purchaser does not acquire any interest in any tooling, drawings, design information, computer programming, patents or copyrighted or confidential information related to said products and the Purchaser expressly agrees not to reverse engineer or decompile such products of related software and information. c) Phvsio shall have the right to cancel or suspend this Agreement at any time upon Purchaser making an assignment for the benefit of creditors or becoming bankrupt or insolvent. or upon a petition being filed in a court of competent jurisdiction proposing the appointrnent of a receiver or that Purchaser is adjudicated bankrupt or insolvent or reorganized under the provisions of any applicable bankruptcy or insolvency law. d) In addition to the rights and remedies reserved herein, Physio shall have all the rights and remedies conferred by law and shall not be required to proceed with performance of the contract arising hereliom if Purchaser is in default to Physic under this or any contract. e) The rights and obligations of Physio and the Purchaser related to the purchase and sale of products and services described in this C10CUment shall be governed by the laws of the State of Washington, United States of America. All costs and expenses incurred by Physio related to enforcement of its rights under this docurent, including reasonable attorney's tees, shall be reimbursed by the Purchaser. 02007 Physic;- Canuoi, Inc., a division of Medtronic. MIN 32Q1819 0 0. IG1i 26,500-002709 VOUCHER NO. WARRANT NO. 'ALLOWED 20 Physio Control IN SUM OF 12100 Collections Center Drive Chicago, IL 60693 $316.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1120 411019640 42- 370.00 $50.00 1 hereby certify that the attached invoice(s), or 1120 411019698 42- 370.00 $266.00 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 Lt r Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by Slate 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)) 411019640 $50.00 411019698 $266.00 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 20 Clerk- Treasurer