171999 04/29/2009 CITY OF CARMEL, INDIANA VENDOR: 355226 Page 1 of 1
ONE CIVIC SQUARE PUBLIC SAFETY CENTER, INC
CARMEL, INDIANA 46032 PO BOX 2370 CHECK AMOUNT: $622.62
EUGENE OR 97402
CHECK NUMBER: 171999
CHECK DATE: 412912009
DEPARTMENT ACCOUNT PO NUMBE IN VOICE NUMBER AMOUNT DESCRIPTION
302 423901.1 176488IN 622.62 SPECIAL DEPT SUPPLIES
Publit' Safety Center, Inc. 'EicctroTdc Tramfcr" I
P.O. Box X370 ACH only (I 'Wife irai�,:ersi)
Pay directly from your bank to ours!
Eugene, OR 97402 P Use our routing# 123205135 Order Date Invoice
and our account 20025714
4/7/2008 176488IN
541-3"-4434 Fax 541 -686 -1373
Bill To Strip To
Carmel Fire Dept Carmel Fire Dept
Attu: Accounts Payable Attu: EMS Dir Mark Hulett
2 Civic Sq 2 Civic Sq
Carmel IN 46032 Carmel IN 46032
P.O. Nuiti Terms Rep Maple involce;Shlp Dace Sillp ma Phone 9
Net 30 Da 4/10/2009 Ground 317/571 -2600
Quantity ttem Code Description Price Each Amount
600 DYND74083 IW Start Kit w /Bioclusive Dressing (each) 0.86 516.00
3 122003 Airway, ColorBerman Airway 80mm 10 /bag 4.77 14.31
3 122004 Airway, ColorBerman Airway 90mm 10 /bag 4.77 14.31
3 122005 Airway, ColorBerman Airway 100mm 10/bag 4.77 14.31
5 NOTE: Remainder of item(s) to follow
15 Shipping (NOTE: Includes shipping for any 63.69 63.69
items to follow)
1 1 FedEx Ground Tracking Number(s): 0.00
073671580023091,0 736 ?1580023107
Total
W- 91NH'O MA1 ION: PUBLIC SAIr&I'Y CENTER 1S AN Uk1EWN CORP FIN 993- 1319770
ANY 1TEM5 RET1TRN D 60 D AYS OR MORE AF` ER RECEIPT ARE SUBJECT T A luv/o RESTOCK FEE.
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VOUCHER NO.- WARRANT NO.
ALLOWED 20
Public Safety Center
IN SUM OF$
P.O. Box 2370
Eugene, OR 97402
$622.62
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT# /TITLE AMOUNT Board Members
1120 176488IN 102- 390.11 $622.62 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
APR 2 7 9899
N3 l r
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))
176488IN $622.62
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