101570 PHYSIO CONTROL CORP INDIANA RETAIL TAX EXEMPT Page 1 of 1
Chitof Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 1 01 570
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL,INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
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
4/11/2018 242000 Preventative Maintenance-Defibrillators
PHYSIO CONTROL CORP Fire Department
VENDOR 12100 COLLECTIONS CENTER DRIVE SHIP 2 Civic Square
TO Carmel, IN 46032-
CHICAGO, IL 60693-
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
24953
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department:. 1120 Fund: 101 General Fund
Account: 43-515.01
1 Each Maintenance Agreement $23,523.00 $23,523.00
Sub Total : $23,523.00
SCANNED
Al-'r 13 2018
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Send Invoice To: -% -6 -A C J
Fire Department
2 Civic Square :
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $23,523.00
SHIPPING INSTRUCTIONS *AlP 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
*SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
*C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
*PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL .--.,,. c„ �� -
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 .‘,1:2,.__)
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AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY - \`
Denise Snyder James Crider `�\�
TITLE Budget&Accreditation Manager Administration `"1\
CONTROL NO. 101570 CLERK-TREASURER