101850 PHYSIO CONTROL CORP INDIANA RETAIL TAX EXEMPT Page 1 of 1
City of Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101850
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
8/7/2018 242000 Additional costs for Defibrillator Maintenance
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
28338
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 101 General Fund
Account: 43-515.01
1 Each Maintenance Agreement-Additional Costs-Old Defibs $2,064.00 $2,064.00
Sub Total $2,064.00
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Send Invoice To: A„ /
Fire Department `` a
2 Civic Square .
Carmel, IN 46032- m.
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT I AMOUNT
PAYMENT $2,064.00
'NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
SHIPPING INSTRUCTIONS
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 <;,
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 9`'' ' " '
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
Denise Snyder ,-:\t )
TITLE Budget&Accreditation Manager k
CONTROL NO. 101850 CLERK-TREASURER