103190 STRYKER MEDICAL /f a INDIANA RETAIL TAX EXEMPT Page 1 of 1
City of I1a]r]r]r]1e1 CERTIFICATE NO.0031201550020 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 103190
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,IV
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
10/29/2019 00351580 Misc.Equipment
STRYKER MEDICAL Fire Department
VENDOR PO BOX 93308 SHIP 2 Civic Square
TO Carmel,IN 46032-
CHICAGO, IL 60673 -
PURCHASE ID BLANKET CONTRACT PAYMENT TERMS FREIGHT
41001
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1120 Fund: 102 Ambulance Capital Fund
Account: 44-670.06
5 Each 11111-000020 ECG Cable 12 Lead-8 ft.Trunk Cable.with AHA Limb Leads $336.60 $1,683.00
6 Each 11171-000049 Masimo Rainbow DCI Adult Reusable Sp02,SpCO,SpMet $544.00 $3,264.00
Sensor, 3 Ft.
6 Each 11171-000050 Masimo Rainbow DCIP Pediatric Reusable Sp02,SpCO3 $599.25 $3,595.50
SpMet Sensor
6 Each 11171-000082 Masino RC Patient Cable-EMS,4 Ft. $378.25 $2,269.50
Sub Total $10,812.00
I
Send Invoice To:
Fire Department
2 Civic Square
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT I ACCOUNT PROJECT I PROJECT ACCOUNT I AMOUNT
PAYMENT $10,812.00
SHIPPING INSTRUCTIONS AIP 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 t
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 ITS
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY ���►111
Denise Snyder James Crider h
TITLE Accreditation Budget Administrator Administration �11�l
CONTROL NO. 103190 CLERK-TREASURER `Q