169197 02/17/2009 CITY OF CARMEL, INDIANA VENDOR: 362454 Page 1 of 1
0 r ONE CIVIC SQUARE VERATHON CHECK AMOUNT: $458.42
CARMEL, INDIANA 46032 20001 NORTH CREEK PARKWAY
BOTHELLWA 98011 CHECK NUMBER: 169197
CHECK DATE: 2/1712009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 180564 458.42 SPECIAL ]KEPI' SUPPLIES
4
r
Invoice Purchase Order
M.Huletticontract
Verathon, Inc. Invoice 180564
16542 Collections Center Drive Date: 1127109 Sales Order SLS176650
Chicago, IL 60693 Order Date: 1127/09 Customer 1046326
United States
Ship Date: 1127/09 Terms: Net 30 Days GFT
r 800 331 2313/425- 867 -1348 Ship Via Ground
425 -883 -2896 Fax Packlist 185739 Formerly Diagnostic Ultrasound
f 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
Reference Ship Qty Unit Price AmOL
0803 -0009 GlideRiteO Stylet Guide, GVL -ST1, Qty 6 3 150.00 450.00 USD
0001 -0001 FREIGHT 1 8.42 8.42 USD
Sub Total $458.42
Tax 0.00
Freight 0.00
Payments 0.00
Grand Total $4 58.42
USD
Prescribed by State Board of Accounts City Form No. 2.01 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
J
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))
180564 EMS Supplies $458.42
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
VOUCHE NO. WARRANT NO.
ALLOWED 20
Vera;hon
IN SUM OF
20001 North Creek Parkway
Bothell, WA 98011
$458.42
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# 1 Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 180564 102 390.11 $458.42 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 T X2(1(19
e
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund