164384 09/30/2008 a CITY OF CARMEL, INDIANA VENDOR: 242000 Page 1 of 1
ONE CIVIC SQUARE PHYSIO CONTROL CORP
CARMEL, INDIANA 46032 12100 COLLECTIONS CENTER DRIVE CHECK AMOUNT: $445.80
CHICAGO IL 60693 CHECK NUMBER: 164384
CHECK DATE: 9/30/2008
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
.102 4239011 PH453409 445.80 SPECIAL DEPT SUPPLIES
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09/10/08 vr� rrcu MARK HULETT rVnl.nnJC Vnv�n CEKKPI .J/+�cv:JCnvi.0 003120155002/mj
EALL71 moorej22 ncrncJCLi Hivt 54: MM14lf1fii• ii isyC C/.rwVtl!'.(j;.;i.;i:;:
CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS
WSGRD 034248618 CN T 1 52659844 -00 Net 30 Days
11996...00:0017 QUIK.COMBO w /REDI -PAK 12 "EA 12 0! 42 0.0 421.80 `E1
r Electrodes Discount 6.85-
L /C: 822119 Expires: 02/2 /11 1
822820 Expires: 02/28/11 1 j
Contact: MAR HULETT
Phone: 317 571 2663
Sub Total! 421.80
I
Freight and Handling 24.00
T HIS PRODUCT: IS S BJECT TO A CONSENT DECREE OF PE ENT I.JUNC ION, FILET
IN UNITE D STATES V MEDTRONIC, ::AND 'PHY
'310 CON R L; IN E AL.,
GIV! NO C08 :!0649;; (W. Di: WASH 2008) UNDER HE TE S OF TH CONSENT DECRE
THE SALE OR DISTRIBUTION: OF THIS::.PRODUCT IS:AU.THO IZ D' >IN IMITED
CIRCUMSTANCES TO MEET'THE SPECIFIC AND ZMME IATE EE S OF RTI` LAR"
(INDIVIDUALS AND a THERESTR IC IONS HE SALE OR:DJSTRIBUTION
�OF THIS: PRODUCT WILL BE REMOVED WHEN PHYSIO CONTROL; INC HASSATISFIED1 .F DA
THAT ITS FACILITIES, METHODS, PROCESSES,; AN ;CONY OL RELA TO THE`
MANUFACTURE AND QUALITY. OF THEjPRODUCT ARE N CON R�ITY WITH THE QUALITY
SYSTEM REGULATION, 2 PART 820 AND T E TER S F THE CONSENT DECREE
317 571 2663 445.80
Site: 20
O R I G I N A L
V e
ACCEPTED
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))
PH453409 EMS Suppliles $445.80
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
VOUCHER NO. WAR N
Physio Control ALLOWED 20
IN SUM OF
12100 Collections Center Drive
Chicago, IL 60693
$445.80
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 PH453409 102 390.11 $445.80 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
v U
Title
Cost distribution ledger classification if
claim pairs motor vehicle highway fund