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HomeMy WebLinkAbout226762 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 357414 Page 1 of 1 ONE CIVIC SQUARE NIGHTINGALE-ALAN MEDICAL, INC CARMEL,INDIANA 46032 11418 DEERFIELD ROAD CHECK AMOUNT: $1,077.93 CINCINNATI OH 45242 CHECK NUMBER: 226762 CHECK DATE: 12/3/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 102 4467006 108079 1, 077 . 93 EMS EQUIP Invoice 108079 Nightingale-Alan Medical Equipment Services, LL( Date 11/12/2013 11418 Deerfield Road Pa'e. 1 Cincinnati OH 45242 (513) 247-8200 1 (800) 332-3700 1 fax (513) 247-8207 Bill To: Ship To: CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL IN 46032 CARMEL IN 46032 Purchase Order No. Customer ID Salesperson ID Ship"'ping Method Pa ment Terms Re Shi Date 111213 MARK CAR04 05 Net 30 _._11/12/2013_ Ordered ' ' shipped B/0 Item Number Description Discount Unit Price Ext.Price 12.00000 12.00000 0.00000 ADC12-0242-000 RESQPOD ITD 10 $0.00000 $89.00000 $1,068.00 FOR WIRE TRANSFER PAYMENTS: There will be a 20% Subtotal $1,068.00 ACCT NAME: NIGHTINGALE ALAN MES LLC Misc' $0.00 ACCT NUMBER: 0073035204 restocking fee Tax_._ $0.00 FIFTH THIRD BANK-ABA#042000314 on all returns unless Freight $9.93 PLEASE INCLUDE INVOICE AND CUSTOMER NUMBERS waived by management Trade.'Discount $0.00 EXAMPLE:999991ABC01 Total T $1,077.93 VOUCHER NO. WARRANT NO. ALLOWED 20 Nigtingale-Alan Medical Equipment Services, L IN SUM OF $ 11418 Deerfield Road Cincinnati, OH 45242 $1,077.93 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 I 108079 1 102-670.06 $1,077.93 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 DEC nr-r 2 to 2nr^ R pq f} r d Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board or 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)) 108079 $1,077.93 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