HomeMy WebLinkAbout168158 01/21/2009 CITY OF CARMEL, INDIANA VENDOR: 355226 Page 1 of 1
ONE CIVIC SQUARE PUBLIC SAFETY CENTER, INC
G 0 CHECK AMOUNT: $814.78
CARMEL, INDIANA 46032 PO BOX 2370
EUGENE OR 97402 CHECK NUMBER: 168158
CHECK DATE: 1/21/2009
DEPARTMENT ACCOUNT PO NUMB INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 170492IN 814.78 SPECIAL DEPT SUPPLIES
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Eugene, OR 97402 U se our routhig 1 2320 513 5 I Order Date I Invoice
and our account 2002571
170492IN
541-344-4434 Fax 541-686-1373
15111 TO Ship TO
Carmel Fire Dept 0
Attn: Accounts Payable I Carmel Fire Dept
2 Civic Sq Attn: Ems Dir Mark Hulett
Carmel XN 46032 2 Civic So
Carmel ZN 46032
I I
P.O. Nuffiriel Tert'ris Rep Nat'lle R [Datt 31 via e✓flurl 4
MARK Net 30 I DaniL 1/6/2009 Ground i 317/571-2600
Quantity item Code Description Price Each Amount
20 31319281pp,(.., Pad, Defib LifePack Physiocontrol, for 33,99 679,80
LP10, LP LP12,LP500 PAIR\)
2 HCS872511 Oxygen Regutator 0-25LPM 570 CGA 49.99 I 99,98
Connection
I Shipping 35.00
Tracking IZACOT710360713674 0.00
I I
I I I 1 I I
Total $,914.78
W-9 INFORMAXIUN: PUBLIC SAFEFY CENTER IS AN UREWN C01UJ FIN 49.3-i31977o
AIVf !TEM S R UR79RD 60 DAY'S' OR MoRE iTT ER RRCEiPT ARE SU} 5ECT TO A I 0 RESTU F—Lh.
VOUCHER NO. WARRANT NO.
0
ALLOWED 20
Public Safety Center
IN SUM OF
P.O. Box 2370
Eugene, OR 97402
$814.78
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 170492IN 102 390.11 $814.78 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 16 2009
Y
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))
170492IN Misc. EMS Supplies $814.78
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