240831 01/07/15 CITY OF CARMEL, INDIANA VENDOR: 294850
® ONE CIVIC SQUARE STOOPS FREIGHTLINER CHECK AMOUNT: $**.....155.30*
f._ ? CARMEL, INDIANA 46032 27825 NETWORK PLACE CHECK NUMBER: 240831
9M,ir_N Via, CHICAGO IL 60673-1278 CHECK DATE: 01/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 X301009434 : 0 155.30 REPAIR PARTS
INVOICE NO. X301009435:01
INVOICE DATE 12/09/2014
7
S�® P.O. NUMBER GARY CARTER
&..
!"OfBfIGNTLINfR-QUALrrITppY TRA'11IFR "' I SHIP VIA PICKUP
QIUISION Of REFERENCE
TRUCK COUNTRY- INDIANAPOLIS
M1LyOWNEpS1F199B 1851 W THOMPSON ROAD
_._ ._-.. . _ _.,,.. ,.._. _, _ _ _ .. INDIANAPOLIS, IN 46217
ALL CLAIMS AND,RETURNED GOODS MUST 6E ACCOMPANIED BY THIS INVOICE:" _.
# NO.RETURNS ON ELECTRICALOR'SPECIAL ORDER PARTS.NO RETURNS.WITHOUTTHIS Phone: (800)899-1533
INVOICE;NO'RETURNS AFTER 30 DAYS.•10%RESTOCK CHARGE-ON ALL RETURNED
Bill To: Ship To:
CARMEL FIRE DEPARTMENT 160874 CARMEL FIRE DEPARTMENT 160874
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL , IN 46032 CARMEL, IN 46032
Phone: (317)571-2600 Phone: (317)571-2600
INVOICE NO.X301009435:01
DATE SHIPPED TERMS SALESPERSON WRITER SHIP VIA UNIT ID VIN
12/9/2014 CHG S1617
QTY QTY UNIT EXT
SHIP B/O ITEM DESCRIPTION ''�:'� BIN 1 PRICE PRICE
1 0 301 F/RDH RD3 8713 1 HEATR'VAVLE „ ,a G02 155.38 155.38
,
.� .�
n
SALES TAX EXEMPTION CERTIFICATE =.`.`-, -`„ DISCLAIMER OF WARRANTIES
1 certify that this transaction is exempt from the Indiana Sales Tax because: ` ANY WARRANTIES ON THE PRODUCTS SOLD HEREBY ARE THOSE MADE Subtotal 155.38
Pur baser is a---on contract came,who will use items purchased or se—d BY MANUFACTURER IF ANY.THE SELLER HEREBY EXPRESSLY.✓'
extlusNely as such canter. DISCLAIMS ALL WARRANTIES EITHER EXPRESS OR IMPLIED INCLUDING
ANY IMPLIED WARRANT'OF MERCHANTABILITY OR FITNESS FOR A O.00
Authority Number. PARTICULAR PURPOSE TAX
AND TRUCK COUNTRY OF Indiana NEITHER
Purchaser is engaged in the business of and items well be used for resale. ASSUMES NOR AUTHORIZES ANYOTHER PERSON TO ASSUME FOR IT ANY
LIABILITY IN CONNECTION WITH THE SALE OF SAID PRODUCTS WE
Resele Number. HEREBY CERTIFY THAT THESE GOODS WERE PRODUCED IN COMPLIANCE
WITH ALL APPLICABLE REQUIREMENTS OF SECTIONSB,7 AND 12 OF THE
I am authorized to execute this Certificate and claim this exception. FAIR LABOR STANDARDS ACT OF 1938,AS AMENDED AND OF
REGULATIONS AND ORDERS OF THE ADMINISTRATOR OR WAGE AND HOUR Total: 155.38
DIVISION ISSUED UNDER SECTION 14 THEREOF.TRUCK COUNTRY DOES
EXPRESS A LIMITED NON-TRANSFERRABLE WARRANTY,TO THE ORIGINAL
B-moss N.M. Authorized Signature PURCHASER,ON TECHNICIAN WORKMANSHIP ISSUES FOR 30 DAYS FROM
THE COMPLETION DATE OF THIS REPAIR ORDER A FINANCE CHARGE OF
ONE AND ONE-HALF PERCENT(1 X%)PER MONTH IS APPLIED TO ALL
ACCOUNTS 3B DAYS PAST DUE THIS EQUALS AN ANNUAL PERCENTAGE
Business Address Data RATE OF EIGHTEEN PERCENT(18%).
RECEIVED
BY:
Please Remit Payment to:
Delivered by: Date: STOOPS FREIGHTLINER
27825 NETWORK PLACE
Customer Signature:
CHICAGO,IL 60673-1278
SIGNATURE an,THE CUsTONER ON CUBTONER REMEaL'NTATIV!CONaTInnEa AGREEMENT TO FAY MASON-LEOAI E VNCEa,
RLCUOING ATTORNEY AND LOUR,,soaring iNCUNIim eY TRUCK COUNTRY FON PAYMENT OF THIS INVOICE
CUSTOMER Page 1 of 1
'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))
X301009434:01 E42 $155.30
1 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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Stoops Freightliner
IN SUM OF $
27825 Network Place
Chicago, IL 60673-1278
$155.30
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 X301009434:01 42-370.00 $155.30 1 hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
)AN
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund