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238645 10/28/14 y u!_4�gy �/ � CITY OF CARMEL, INDIANA VENDOR: 178450 ONE CIVIC SQUARE KUSSMAUL ELECTRONICS CO IN CHECK AMOUNT: $*******387.41* s; �� CARMEL, INDIANA 46032 170 CHERRY AVE CHECK NUMBER: 238645 +��oN,.�� WEST SAYVILLE NY 11796-1221 CHECK DATE: 10/28/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4350900 39397 12.11 OTHER CONT SERVICES 1120 4350900 39468 126.86 OTHER CONT SERVICES 1120 4350900 39473 248.44 OTHER CONT SERVICES I EKUSSMAUL Invoice No 0000039397 J ELECTRONICS Remit To: Phone:800-346-0857 170 Cher Ave. Cherry 75-00 Fax:631-567-5826 West Sayville, Sales Order No 0298 E-Mail:sales@kussmaul.com NY 11796 Packing List No 033065 Bill to : CAR033 Ship to : CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL IN 46032 CARMEL IN 46032 United States United States Phone(317)571-2600 Customer PO Number Invoice Date Terms FOB Ship Via Coordinator BC4 10/14/2014 NET 30 DAYS WEST SAYVILLE,NY UPS GROUND CST Item Part/Description Serial Number Quantity Unit Price Extended Price 000010 091-55-20-120-BW-YW 1.00 0.00000 0.00 SUPER AUTO EJECT 120 VOLT AC 20 AMP 000020 091-55-20-120-BW 1.00 0.00000 0.00 SUPER AUTO EJECT 120 VOLT AC 20 AMP 520140634 1 Kit Item 000030 091-55YW 1.00 0.00000 0.00 WEATHERPROOF COVER,YELLOW Kit Item 000040 WARRANTY REPLACEMENT 1.00 0.00000 0.00 REPLACING A UNIT UNDER WARRANTY 000050 SHIPPING 1.00 12.11000 12.11 Shipping/Freight Charge,Ref Shipper No 0330_65 _ — Shipped on 10/14/2014 Thank you for your order. Total Item Price 0.00 Tracking# 1Z1335780322160031 Shipping 12.11 Sales Tax 0.00 Total Inv Price US$ 12.11 Please pay balance due by Thursday November 13 201 L CUSTOMER COPY Page 1 Authorized Signature �KUSSMAUL Invoice No 0000039468 ELECTRONICS Remit To: Phone:800-346-0857 170 Cherry Ave. Sales Order No 029930-00 Fax:631-567-5826 West Sayville, E-Mail:sales@kussmaul.com NY 11796 Packing List No 033148 Bill to : CAR033 Ship to : CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL IN 46032 CARMEL IN 46032 United States United States Phone(317)571-2600 Customer PO Number Invoice Date Terms FOB Ship Via Coordinator A42 10/15/2014 NET 30 DAYS WEST SAYVILLE,NY FED-EX GROUND RESIDENTIAL CST Item Part I Description Serial Number Quantity Unit Price Extended Price 000010 REPAIR OF 091-18WP-120 1.00 113.00000 113.00 S/N:W2100477 REPAIR#:AC36875 000020 SHIPPING 1.00 13.86000 13.86 Shipping/Freight Charge, Ref Shipper No 033148 Shipped on 10/15/2014 Thank you for your order. Total Item Price 113.00 Tracking# 023887570032225 Shipping 13.86 Sales Tax 0.00 Total Inv Price US$ 126.86 Please pay balance due by Friday November 14 2014. CUSTOMER COPY Page 1 Authorized Signature EKE]KUSSMAUL Invoice No 0000039473 ELECTRONICS Remit To: Phone:800-346-0857 170 Cherry Ave. Sales Order No 029931-00 Fax:631-567-5826 West Sayville, E-Mail:sales@kussmaul.com NY 11796 Packing List No 033117 Bill to : CAR033 Ship to : CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL IN 46032 CARMEL IN 46032 United States United States Phone(317)571-2600 Customer PO Number Invoice Date Terms FOB Ship Via Coordinator E44 10/15/2014 NET 30 DAYS WEST SAYVILLE,NY j FED-EX GROUND RESIDENTIAL CST Item Part/Description Serial Number Quantity Unit Price Extended Price 000010 REPAIR OF 091-96-1 1.00 230.00000 230.00 S/N: 15277 REPAIR#:AC36877 000020 SHIPPING 1.00 18.44000 18.44 Shipping/Freight Charge, Ref Shipper No 033117 Shipped on 10/15/2014 Thank you for your order. Total Item Price 230.00 Tracking# 023887570032188 Shipping 18.44 Sales Tax 0.00 Total Inv Price US$248.44 Please pay balance due by Friday November 14 2014. — CUSTOMER COPY Page 1 Authorized Signature I VOUCHER NO. WARRANT NO. ALLOWED 20 Kussmaul Electronics IN SUM OF$ 170 Cherry Avenue West Sayville, NY 11796 $387.41 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 39473 43-509.00 $248.44 1 hereby certify that the attached invoice(s), or 1120 39397 43-509.00 $12.11 bill(s) is (are)true and correct and that the 1120 39468 43-509.00 $126.86 materials or services itemized thereon for which charge is made were ordered and received except 0-C1 2T2014 ( Fire Chie - Title i Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No.201(Rev.1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by whom, rates per day, number of hours,rate per hour, number of units, price per unit,etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s)or bill(s)) 39473 $248.44 39397 $12.11 39468 $126.86 I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 , 20 Clerk-Treasurer