202344 09/27/2011 CITY OF CARMEL, INDIANA VENDOR: 365681 Page 1 of 1
ONE CIVIC SQUARE VIDACARE CHECK AMOUNT: $217.13
CARMEL, INDIANA 46032 DEPT 2474
PO BOX 122474 CHECK NUMBER: 202344
DALLAS TX 75312 -2474
CHECK DATE: 9127/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 17432 217.13 SPECIAL DEPT SUPPLIES
V I ca c a ma INVOICE
Defining the Field of Intraosseous Medicine" INVOICE NO. INV. DATE COST. NO. GLN. NO. P NO.
Vidacare Corporation 17432 09/08/201 I 14753 1
4350 Lockhill Selma Suite 150
Shavano Park 78249 REMIT TO
Dept 2474
PO Box 122474
Dallas, TX 75312 -2474
BILL TO SKIP 'r0
Carmel Fire Department Carmel Fire Department.
Attn: Accts Payable Attn: Receiving
2 Civic Square 2 Civic Square
Carmel IN 46032 Carmel IN 46032
USA USA
SHIPPED D ATE P URCHA SE OR N O. E SGround 09/08/2011 Verbal Net 30
SALESPERSON EMAIL PHONE EIN DKB
Coutiney DeWitt jim.fcrrara@vidacare.cO01 773447 -2162 74- 2899035 12 -578 -7676
REMARKS: TILACKING NO.
Based On Sales Orders 11576. Based On Deliveries 16595. 17AOI IZ830350090024
1'1'E NO. DESCRIPTION Q "1'1' Sill l'1'ED BACK ORDER UNITPRICE TOTAL
9074 G3 Hard -Sided Carrying Case 11 0 18.9500 S 208.45
SUBTOTA1, S208.45
DISCOUNT 50.00
FREIGHT 58.68
TAX $0.00
TOTAL INVOICE $217.13
AMOUNT PAID ON INVOICE S0.00
PLEASE REMIT THIS AMOUNT 217.13
Claims as to price, shortage or otherwise, must be reported within 7 days of a shipping date. Products may not be returned without prior approval and are subject to a 25%
restocking fee. Delivery and acceptance of the items listed herein represents an agreement by purchaser that the obligation presented on the related invoice is due and payable
at the office of the company shown above within 30 days from the date of the invoice. Custom products are not returnable.
Contact us at: Tel 866 479 -8500 Email: VASales @vidacare.com Website: www.Vidacare.com
VOUCHER NO. WARRANT N
ALLOWED 20
Vidacare
Dept. 2474 IN SUM OF
PO Box 122474
Dallas, TX 75312 -2474
$217.13
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. I ACCT #!TITLE AMOUNT Board Members
1120 I 17432 1 102 390.11 I $217.13 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
SEP 2 2011
7 d L -o—
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))
17432 $217.13
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