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24582 Physio Control City of Carmel INDIANA RETAIL TAX EXEMPT PAGE City o l\ .armel CERTIFICATE NO.003120155 002 0 N �� N \L/ u �/ �Y 1l PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 24582 35-60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,NP CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SUPS, SHIPPING LABELS AND ANY CORRESPONDENCE. FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 41252014 \ay.�� . Cc• --, . Physio Control Carmel Fire Department VENDOR SHIP 2 Carmel Civic Square TO 12100 Collections Center Drive Cannel, IN 46032 Chicago, IL 60693 (317)571-2622 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT �Q NTITY �OF MEASURE'E \ DESCRIPTION UNIT PRICE EXTENSION Account 43-515.01 1 Each Maintenance Contract $23,874.00 $23,874,00 . 'Th\-- `-•<s7; •_C` c . ■_S Sub Total: $23,874.00 S . /rrr . • 0 C?'''. :•5 .'0 SI et t /+* .. ti Send Invoice To: U� " 0 U V © , # • � .r1 /` Cannel Fire Department 2 Cannel Civic Square Cannel, IN 46032- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Cannel Fire Department PAYMENT $23.874.00 • NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS • I HEREBY CERTIFY,THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPFIATINT TO PAY F ORDER. •SHIP REPAID. Acil:te""'"..‘-fc)■-.0--2-40--.4.-.—.1•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY •PURCHASE SR NUMBER MUST APPEAR ON ALL SHIPPING P/NG LABELS. if . •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 24582 CLERK-TREASURER DOCUMENT CONTROL NO. OFFICE COPY •