HomeMy WebLinkAbout221663 07/02/2013 CITY OF CARMEL, INDIANA VENDOR: 242000 Page 1 of 1
�` ONE CIVIC SQUARE PHYSIO CONTROL CORP CHECK AMOUNT: $21,699.00
+ CARMEL, INDIANA 46032 12100 COLLECTIONS CENTER DRIVE
CHICAGO IL 60693 CHECK NUMBER: 221663
CHECK DATE: 7/2/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351501 414000726 18, 809 . 40 EQUIPMENT MAINT CONTR
1120 4351501 414000831 2, 889 . 60 EQUIPMENT MAINT CONTR
a Product Billing Page 1
I I
Physio-Control, Inc. INVOICE
11811 Willows Road NE
Post Office Box 97006 Mail payments only to this address:
Redmond,WA 98073-9706 USA 12100 Collections Center Drive 414000726
Telephone: 425.867.4000 Chicago,IL 60693
Fax: 425.881.2405 Please reference Invoice Number on your check.
F.E.I.N. 91-0697691 For Inquiries,Call toll free 1-800-426-8047 5/1/13
BILL TO ACCOUNT: 10774201 SHIP TO ACCOUNT: 10774201
CARMEL FD CARMEL FD
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL, IN 46032 CARMEL, IN 46032
DATE SHIPPED PURCHASE ORDER NUMBER
SALES/SERVICE REPRESENTATIVE T=TAXABLE E=EXEMPT
5/2/13 P6151-1796
CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS
C0178315 NET30
ANNUAL FOR MAINTENANCE AGREEMENT: 1.00 18810.0 18,810.00
P13151-1796 PERIOD:05/01/13 to
04/30/14
Contact:Mark Hulett
Phone:317-571-2663
Terms:
15%DISCOUNT ON ACCESSORIES
15%DISCOUNT ON ALL DEFIB/PACING
ELECTRODES
Sold Cust: 10774201
Fax:
Sales Tax 0.00
Freight and Handling 0.00
Total Order $18,809.40
NOTE: TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN.
s Product Billing Page 1
I I
Physio-Control, Inc. INVOICE
11811 Willows Road NE
Post Office Box 97006 Mail payments only to this address:
Redmond,WA 98073-9706 USA 12100 Collections Center Drive 414000831
Telephone: 425.867.4000 Chicago,IL 60693
Fax: 425.881.2405 Please reference Invoice Number on your check.
F.E.I.N. 91-0697691 For Inquiries,Call toll free 1-800-426-8047 5/1/13
BILL TO ACCOUNT: 10774201 SHIP TO ACCOUNT: 10774201
CARMEL FD CARMEL FD
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL, IN 46032 CARMEL, IN 46032
DATE SHIPPED PURCHASE ORDER NUMBER SALES/SERVICE REPRESENTATIVE T=TAXABLE E=EXEMPT
5/2/13 P1151-1951
CARRIER CARRIER TRACKING NUMBER SALES ORDER PAYMENT TERMS
C0178420 NET30
ANNUAL FOR MAINTENANCE AGREEMENT: 1.00 2890.0 2,890.00
PI 151-19511 PERIOD:05/01/13 to
04/30/14
Contact:Mark Hulett
Phone:317-571-2663
Terms:
15%DISCOUNT ON ACCESSORIES
15%DISCOUNT ON ALL DEFIB/PACING
ELECTRODES
Sold Cust: 10774201
Fax:
I
Sales Tax 0.00
Freight and Handling 0.00
Total Order $2,889.60
NOTE: TERMS CONTAINED ON THE REVERSE SIDE OF THIS DOCUMENT ARE EXPRESSLY MADE A PART OF THIS SALES AGREEMENT AND ARE INCORPORATED HEREIN.
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))
414000726 Maintenance Contract $18,809.40
414000831 Maintenance Contract $2,889.60
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
Physio Control
IN SUM OF $
12100 Collections Center Drive
Chicago, IL 60693
$21,699.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 414000726 43-515.01 $18,809.40 1 hereby certify that the attached invoice(s), or
1120 414000831 43-515.01 $2,889.60 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 —4 202
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund