102117 PYSIO 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 102117
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
2M APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
11116/2018 242000 AED's
PHYSIO CONTROL CORP Fire Department
VENDOR 12100 COLLECTIONS CENTER DRIVE SHIP 2 Civic Square
TO Carmel, IN 46032-
CHICAGO, IL 60693 -
PURCHASE ID I BLANKET CONTRACT PAYMENT TERMS FREIGHT
31057
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-670.99
12 Each 80403-000148 LifePak CR Plus AED Kit Semi-Automatic AHA Voice Prompt $1,756.00 $21,072.00
1 Each Shipping $185.00 $185.00
Sub Total $21,257.00
Yr
}
44
8 i I
Li 1
Send Invoice To:
Fire Department '' .4s 6,
I
2 Civic Square
�: , ,
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT I PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT $21,257.00
'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
— ''JP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
J.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
*PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL -- b G% -
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 "`'" ''''" `" -€M
`)
ORDERED BY
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. A
Denise Snyder James CriderTITLE Budget&Accreditation Manager Administration \
CONTROL NO. 102117 CLERK-TREASURER