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Home My WebLink About168737 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 362454 Page 1 of 1 ONE CIVIC SQUARE VERATHON O la CARMEL, INDIANA 46032 20001 NORTH CREEK PARKWAY CHECK AMOUNT: $48,110.52 80THELL WA 98011 CHECK NUMBER: 168737 CHECK DATE: 2/4/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4467006 12632 179400 48,110.52 GLIDESCOPES a 1 •R N Invoice Purchase Order 12632 Verathon, Inc. Invoice 179400 PO BOX 3555 Date: 1/14/09 Sales Order SLS175060 Seattle, WA 98124 -3555 Order Date: 1/13/09 Customer 1046326 United States Ship Date: 1/14/09 Terms: Net 30 Days GIFT 800 331 23131425 -867 -1348 Ship Via Ground 425- 883 -2896 Fax Packlist 184472 Formerly Diagnostic Ultrasound 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- U nit Price Amou 0270 -0415 GlideScope® Ranger System, Single Use 3- 1 9,825.00 9,825.00 USD RV082166 0570 -0198 Ranger Video Baton 3 -4 1 0.00 0.00 USD RB082101 0270 -0415 GlideScope® Ranger System, Single Use 3- 1 9,825.00 9,825.00 USD RV082167 0570 -0198 Ranger Video Baton 3 -4 1 0.00 0.00 USD R6082054 0270 -0415 GlideScope@ Ranger System, Single Use 3- 1 9,825.00 9,825.00 USD RV082168 0570 -0198 Ranger Video Baton 3 -4 1 0.00 0.00 USD RB082055 0270 -0607 GlideScopee) Ranger Video Baton 1 -2 Kit 1 5,850.00 5,850.00 USD RP081405 0270 -0607 GlideScope® Ranger Video Baton 1 -2 Kit 1 5,850.00 5,850.00 USD RP081406 0270 -0607 GlideScopeO Ranger Video Baton 1 -2 Kit 1 5,850.00 5,850.00 USD RP081427 0270 -0444 GVLO 4 STAT Box/10 2 142.88 285.76 USD 224 0270 -0446 GVL@ 3 STAT Box/10 2 142.88 285.76 USD 244 0270 -0429 GVL® 2 STAT Box/10 1 190.00 190.00 USD 16 0270 -0428 GVL® 1 STAT Box/10 1 190.00 190.00 USD 11 0900 -1455 Training Pack, GlideScopelD Ranger- EN 3 0.00 0.00 USD 0001 -0001 FREIGHT 1 134.00 134.00 USD Sub Total $48,110.52 Tax 0.00 y V E RATH 0 CSI Invoice Purchase Order 12632 Verathon, Inc. Invoice 179400 PO BOX 3555 Date: 1114109 Sales Order SLS175060 Seattle, WA 98124 -3555 Order Date: 1113109 Customer 1046326 United States Ship Date: 1/14/09 Terms: Net 30 Days GFT 800- 331 23131425- 867 -1348 Ship Via Ground 425- 883 -2896 Fax Packlist 184472 Formerly Diagnostic Ultrasound Bill To Ship To City of Carmel Fire Department City of Carmel Fire Department Attn: Accounts Payable 2 Civic Scl 2 Civic Sol Carmel, IN 46032 -2584 Carmel, IN 46032 -2584 United States United States Reference Ship Qty Unit'Price Amount Freight 0.00 Payments 0.0 Grand Total $48,11 USD 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)) 179400 Gidescope System $48,110.52 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 Cleric- Treasurer VOUC NO. WARRA NO. ALLOWED 20 Verathon IN SUM OF 20001 North Creek Parkway Bothell, WA 98011 $48,110.52 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members 12632 179400 102 670.06 $48,110.52 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 FEB —2 2 C A Fire Ch Title Cost distribution ledger classification if claim paid motor vehicle highway fund