09-119 Seattle King County Public Health for AED Purchase - City of ...

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PHILIPSPhilips Healthcare3000 Minuteman Road, MS 0400Andover, MA 01810Issue Date Invoice number12/21/2009 93710294 Page 2 / 3Due Date Order Date Order number01/20/2010 12/08/2009 6300449243Purchase Order Number:103530INVOICEREPRINTPayment terms:Net 30 DaysItem Article - / type number / description Qty UnitUnit Amt( USD)Total amount( USD)AO9L-030660020 M5085A861295HS1 Trainer, Philips, Guidelines 2005 2Agreement DiscountPCE 295.00 590.00-35.00 % -206.50Net Value Not Including Freight383.50Bill of Lading: 411624536154Ship Date :Route :Carrier : FEDEX0030 M5070A989803121381Commodity code : 9023000000Agreement #: MH175HS1 Battery Pack 2Agreement DiscountPCE 125.00 250.00-35.00 % -87.50Net Value Not Including Freight162.50Bill of Lading: 411624536154Ship Date :Route :Carrier : FEDEXCommodity code : 8506100000Agreement #: MH175Total Gross Value 5,517.001 cer—Li that these goods or serviceshave been recejlved161KAu crazed Signaturedoh 09 5 6 go-Acct No. or PC No. Cancel no? ❑Discount Amount -1,930.95Net Value 3,586.05Total tax 340.67Total 3,926.72Please pay on this invoice. No statement will be issued.
PHILIPSPhilips Healthcare3000 Minuteman Road, MS 0400Andover, MA 01810Issue Date12/21/2009Invoice number93710294Due Date Order Date Order number01/20/2010 12/08/2009 6300449243Purchase Order Number:103530Page 3 / 3INVOICEREPRINTPayment terms:Net 30 DaysUnit AmtTotal amountItem Article - / type number / descriptionQty Unit( USD)( USD)Seller represents that these goods were produced in compliance with all applicable requirements of section 6, 7 and12 of theFair Labor Standards Act, as amended herein regulations and orders of the United States Department of Labor issued undersection 14 thereof.The following clause only refers to US-origin products as indicated in this document:These commodities, technology or software were exported from the United States for ultimate destination United States inaccordance with the Export Administration Regulations. Diversion contrary to U.S. law is prohibited.Health Care Providers are reminded that if the purchase of goods or services includes a discount, such as a price reduction ora loan of goods at reduced cost, they must fully and accurately report such discount on cost reports or other applicable claimsfor payment submitted under any Federal Health Care Program, including but not limited to Medicare and Medicaid as requiredby Federal law (see 42 USA 1320a - 7(b)(3) and 42 CFR 1001.952(h)).Please pay on this invoice. No statement will be issued.
Page 1 and 2: REQUESI TO PURCHM3E FORMGoods (DV)
Page 3 and 4: A ED State contract Page 2 of 2We a
Page 5 and 6: "RRFinance andBusiness Operations D
Page 7 and 8: Objective:King County Project RAMPA
Page 9: Lia-HER. . ::GAW, OrW liQN .Finante
Page 12: Issue Date12/21/2009Invoice number9
Page 16 and 17: Page 2 of 2Is there any thing else
Page 20 and 21: CITY OF WOODINVILLE17301 133RD AVEN
Page 22 and 23: Packing ListPHILIPSPHILIPSCUSTOMER
Page 24 and 25: SHIPPER'S DECLARATION FOR DANGEROUS
Page 26 and 27: RAMPART GrantPurpose: The RAMPART G
Page 28 and 29: King County Project RAMPARTRegional
Page 30 and 31: King County Project RAMPART -Region
Page 32 and 33: RCW 42.30.020: Definitions. Page 1
Page 34 and 35: State of WashingtonCurrent Contract
Page 36 and 37: Current Contract InformationContrac
Page 38 and 39: CONTRACTOR INFORMATIONContractor: P
Page 40 and 41: M5089A External Manikin Adapter, 5-
Page 42 and 43: CONTRACTOR INFORMATIONContractor: Z
Page 44 and 45: PRICE SHEETS — ZOLL MEDICAL CORPO
Page 46 and 47: PRICE SHEETS — CA IAC SCIENCEA J,
Page 48 and 49: PERFORMANCE REPORT FORTo OSP Custom
Page 50: WOODINVILLEPriv City Co.Count Corn

09-119 Seattle King County Public Health for AED Purchase - City of ...

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