192213 11/23/2010 CITY OF CARMEL, INDIANA VENDOR: 364867 Page 1 of 1
ONE CIVIC SQUARE QUAD MED, INC.
PO BOX 550773 CHECK AMOUNT: $985.00
CARMEL, INDIANA 46032
JACKSONVILLE FL 32255 -0773 CHECK NUMBER: 192213
CHECK DATE: 11/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 50478 985.00 SPECIAL DEPT SUPPLIES
V��uoot MWOCE
7 uadMed Inc. xmwvvquodmedcom Invoice Number: 50478
Emergency Medical Products wak»o@qumdmmd.onm Invoice Date: Oct 18.2O10
Page: 1
P.O. BOX 550773
JACKSONVILLE, FL 32255-0773
Voice: 800'933-7334
Fax: 877'357-7759 Sales Order: 3428O
EMI To:
CITY OFCARK8EL FIRE DEPT CARMELFD
2 CIVIC SQUARE 2 CIVIC SQUARE
CARk4EL.|N 48032 CARKXEL.|N 46032
Customer ID custom P
CARMELFD MARK Net 30 Days
Sales Re I D
UPS Ground 10118/10 11/17/10
10.00 BOX EDI-3003-AV ACUVANCE 20G IV CATH 50/BX —MUST 98.50 985.00
BE 3356**
Subtotal 985.00
Sales Tax
Total Invoice Amount 985.00
Check/Credit Memo No: Payment/Cred it Applied
Freight
Your balance asnf Oct 18 iu985.00. This balance does not reflect payments or charges processed after that date.
RetumedGomb Written ammmt�ation must bo obtained pfior to retuming merchandise. All returns should be sent within 30 days in resalable condition. Retums are
ou0jer/oa2n% restocking charge. &ench*ndisohold longer than 90 days, o/ custom items, are not returnable. All returned goods must 8e sent prepaid.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Quad Med, Inc.
IN SUM OF
P.O. Box 550773
Jacksonville, FL 32255 -0773
$985.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 50478 102 390.11 $985.00 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
N 2 2 2010
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))
50478 $985.00
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