211844 08/14/2012 CITY OF CARMEL, INDIANA VENDOR: 362944 Page 1 of 1
0 ONE CIVIC SQUARE LIFESAVERS, INC
CARMEL, INDIANA 46032 39 PLYMOUTH STREET CHECK AMOUNT: $1,535.00
FAIRFIELD NJ 07004 CHECK NUMBER: 211844
CHECK DATE: 8/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1091 4239012 47068 1, 535 . 00 SAFETY SUPPLIES
Invoice
39 Plymouth Street Date Invoice#
Fairfield NJ 07004 777W ® IT 7/26/2012 47068
Phone:(973)244-9111 Fax:(973)244-1666
Bill To Ship To
Carmel Clay Parks Recreation Carmel Clay Parks& Recreation
Administrative Offices Attn: Eric Mehl
141 1 E. 1 16th Street 1235 Central Park Dr E.
Carmel IN 46032 Carmel, IN 46032
P.O. Number Terms Due Date Rep Ship Via F.O.B.
31092 Net 30 8/25/2012 MG Fed Ex origin
Quantity Item Code Description Price Each Amount
s M5070A Philips Heartstart Onsite FRX 4yr Battery 153.00 765.00
5 M5071A Philips Onsite Adult Smart Pads Cartridge 59.00 295.00
5 M5072A Philips Onsite Pediatric Smart Pad Cartridge 95.00 475.00
#9612019010756760213675
Purchase
Description AED Accea'ies rgq(�i��mejr
P.O.# 31017? P OT
.L.# /b9/• �z�9or2
Budget `'ice
ne escr v1
Purchaser Date
Approval Date
All Discrepancies must be reported within s days after receipt of products(973)244-91 1 1
Total $1,535.00
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
362944 LifeSavers, Inc. Terms
39 Plymouth Street
Fairfield, NJ 07004
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
7/26/12 47068 AED Accessories replacement 31092 $ 1,535.00
Total $ 1535.00
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.
362944 LifeSavers, Inc. Allowed 20
39 Plymouth Street
Fairfield, NJ 07004
In Sum of$
$ 1,535.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members
Dept#
1091 47068 $ 1,535.00 1 hereby certify that the attached invoice(s), or
4239012 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
9-Aug 2012
Signature
$ 1,535.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund