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HomeMy WebLinkAbout175202 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 362454 Page 1 of 1 ONE CIVIC SQUARE VERATHON l CHECK AMOUNT: $1,995.00 CARIJIEL, INDIANA 46032 20001 NORTH CREEK PARKWAY BOTHELL WA 98011 CHECK NUMBER: 175202 CHECK DATE: 7/22/2009 DEPARTMENT ACCOUN PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4467006 196782 1,995,00 EMS EQUIP Invoice Purchase Order VERATHON5 126641exchange Invoice 196782 Remit to: Date: 6130109 Sales Order SLS188581 -1 Verathon, Inc. Order Date: 6130109 Customer 1046326 16542 Collections Center Drive Ship Date: 6130/09 Terms: Net 30 Days GFT Chicago, IL 60693 United States Ship Via Ground Packlist 203125 Formerly Diagnostic Ultrasound 800- 331 2313/425 -867 -1348 425- 883 -2896 Fax Bill To Ship To City of Carmel Fire Department City of Carmel Fire Department Attn: Accounts Payable 2 Civic Sq 2 Civic Sq Carmel, IN 46032 -2584 Carmel, IN 46032 -2584 United States United States Part Description /Serial Number(s) Ship Qty Unit Price Amount 0270 -0617 Ranger, GlideScope® DVR 1 1,995.00 1,995.00 USD DR091584 0001 -0001 Freight 1 0.00 0.00 USD Sub Total $1,995.00 Tax 0.00 Freight 0.00 Payments 0. Grand Total $1,995.00 USD r 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)) 196782 $1,995.00 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 VOUCHER NO, WARRANT NO. ALLOWED 20 Vera_thon IN SUM OF 20001 North Creek Parkway Bothell, WA 98011 $1,995.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# 1 Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 1120 196782 102- 670.06 $1,995.00 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 JUL 2 U Z009 r Vd e .7 1 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund