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I <br /> I <br /> I <br /> I <br /> I <br />,I <br /> I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />*INVOICE* <br /> <br /> PLEASE PAY FROM THIS INVOICE <br /> <br />* MEDI-RENTS & SALES * <br />*Div. Medical Equipment Minnesota * <br />* 7117 WEST BROADWAY * <br />* BROOKLYN PARK, MN 55369 * <br />* (612) 566-1008 * <br />*********************************** <br /> <br />*INVOICE* <br /> <br />Bill to: <br /> <br />Richard Spicer, Atty <br />Midland Bank Building #1028 <br />410 2nd Ave So. <br />Minneapolis, MN 55404 <br /> <br /> copy <br />Delivered to: <br /> <br />Richard Buchite <br />19171 Tyler St <br />Elk River, MN 55332 <br /> <br />Disk code #282; File name: BUCHITRI; dt#811020; Initial:... <br /> <br />************************************************************ <br />P~ovider # M 12712 ME <br />Employer: City of Ramsey,.Minnesota <br />Prescribing physician: Dr. Charles Lei & Noran ..... <br />Rental period: 08/20/82 thru 09/19/82' ~ <br /> <br />Equipment rented: ~ ~ <br />Fully electrical hospital bed with hand held <br />controls for head, knee and bed height and <br />manual emergency powerout by-pass; Orthopedic <br />Innerspring Mattress (gat'ch type) X.F. 35x80 <br />with staphcheck- $164.50 <br />Full overhead traction/fracture frame tri- <br />bar with ortho pull and chain $ 45.00 <br />Side rails for hospital bed $ 23.50 <br />Bucks Triple pulley pelvic traction $ 45.00 <br />Orthopedic Laminectomy Chair w 7/8"Elev arms $ 36.50 <br /> Current monthly rental total .... ~[~6 <br /> <br />I.~ive state area delivery. Emergency service 24 hours a clay <br />?~bject to after hours charge. Minimum rental period is <br />monfh unless o~.~herwise stated. Rates are subject to weekly <br />p~'~-o~'ation after the first month. Payments for rentals are <br />~]ue ,~t the beginning of each rental period. An agreement <br />has b~..en established for renting only, ahd not of sale. <br />~tal ite~ns may be purchased - one month of paid rental <br />~:~y be at>plied to the purchase price. One-half ~'~nth' s <br />~:<~,~tal fr~e when three months rental is paid in advance. <br />P~]ces are subject to change without notice - items and <br />~-;rvice s,~bject to availability <br />T~{E t~AT/ENT HAS ASSIGNED PAYMENTS DIREC'FLY TO T}{E VENDOR. <br /> <br /> <br />