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Home My WebLink About161753 07/23/2008 CITY OF CARMEL, INDIANA VENDOR: 361537 Page 1 of 1 ONE CIVIC SQUARE CARDIAC SCIENCE CORP CARMEL, INDIANA 46032 DEPT 0587, PO BOX 120587 CHECK AMOUNT: $1,725.00 DALLAS TX 75312 CHECK NUMBER: 161753 CHECK DATE: 7/23/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AM OUNT DESCRIPTION (1115 4467099 18393 1053837 T 1,725.00 SIGNS /WALL MOUNT A C, RDIAC REMIT TO: INVOICE Cardiac Science Corp. Invoice No.: 1053837 c f e n ca Dept. 0587 P.O. Box 120587 Page 1 of 1 Dallas, TX 7531 2 -0587 Date: 07/14/08 Bill to: CITY OF CARMEL COMM. DEPT Ship to. CITY OF CARMEL COMM. DEPT 31 1ST AVE NW 31 1ST AVE NW CARMEL, IN 46732 ATTENTION JANET AMONE USA CARMEL IN 46732 iCUStOnler No q� *Sales OrCIerNO .ur a, C.USt I?C) !Reference SaleS,�?Er50nt 77028 B803761 18393 MADDEN, SHELLIE FOBtr f� �s�., rlms aC nc a..... der urr ..Ye�� FEDX Ground FOB Orgin net 30 USD US Dollars a a.. a a t m .time g 0.1tem Description U/M Qt Ord F Qt Sh Um Price Amount° a3 a"� a a€ h 7 P 97 nga .v a r,; .-sue �"3L a'1, .3 T Shap� ®a kin No a, R.R �S /tV 9390E -501 G3 PLUS, AED, ENGLISH, PKG EA 1.00 1.00 1,695.00 1,695.00 7/14/2008 9612019259245370775262 4206484 9131 -001 ELECTRODES, DEFIBRILLATION G3 EARLIER EA 1.00 1.00 0.00 0.00 7/14/2008 9612019259245370775279 5550 -003 READY KIT,AMBU,G3 AED EA 1.00 1.00 0.00 0.00 7/14/2008 9612019259245370775279 168- 6000 -001 SOFT -SIDED CARRYING CASE, AED 2.0 EA 1.00 1.00 0.00 0.00 7/14/2008 9612019259245370775279 180- 2021 -001 ASSY,WALL CASE,G3 AED,ELECTRONIC EA 1.00 1.00 0.00 0.00 7/14/2008 9612019259245370775286 168- 6002 -001 Kit, AED Labels and Wall Sign EA 1.00 1.00 30.00 30.00 7/14/2008 9612019259245370775279 9928 -001 Prescription for AED EA 1.00 1.00 0.00 0.00 7/14/2008 9612019259245370775279 Contact info: Net' Sale `RMlsc, Chg�� hip Handling F Tax Customer care phone: 1- 800 -426 -0337 1,725.00 0.00 0.00 0.00 Customer care e -mail: care @cardiacscience.com Credit services phone: (425) 402 -2200 T Credit services e -mail creditservices @cardiacscience.com ArnountDue Fed Tax ID: 94- 3300396 1 RI- 128606035155869750 -48 -258 INDIANA RETAIL TAX EXEMPT PAGE Cit� I' Carmel CERTIFICATE NO. 003120155 002 0 o 1�. PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 18393 35- 60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 711912008 Cardiac Science Corporation Carmel Clay Communications SHIP 31 First Avenue NW VENDOR Dept. 0587, PO Sox 120587 T Carmel, IN 4W32 Dallas, TX 75312 (317) 571-2586 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Accou 44- 670.99 1 Each 3 -D Wall Mount Sign 168.6002 -001 $30.00 $30.00 1 Each AED Semi-Automatic PackagewAivali 9390E 501WP $1,695.00 $1,695.00 case Sub Total: $1,725.00 j s R a tl•° a 1,:; j a a 5 t 'aria Send Invoice To: Carmel Clay Communications 31 First Avenue NW Carmel, IN 46032 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Communications PAYMENT $1,725.00 A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PA. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED, SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO "PAY FOR THE ABOVE ORDER- SHIP REPAID. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. 1 ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL r•`` SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. DOCUMENT CONTROL NO. A.� COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO.- ALLOWED 20 IN THE SUM OF a ON ACCOUNT OF APPROPRIATION FOR a Board Members PO## or INVOICE NO. ACCT /TITLE AMOUNT DEPT I 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_ 20 j Signature Title I Cost distribution ledger classification if claim paid motor vehicle highway fund VOUCHER NO. WARRANT NO. ALLOWED 20 Cardiac Science Corporation IN SUM OF Dept. 0587, PO Box 120587 Dallas, TX 75312 I $1,725.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Clay Communications PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 18393 1053837 44- 670.99 $1,725.00 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 Friday, July 18, 2008 •04�.+ Director 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)) 07/14/08 I 1053837 I I $1,725.00 1 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