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241742 02/03/15 `'u �qp''f CITY OF CARMEL, INDIANA VENDOR: 131135 ® i`. ONE CIVIC SQUARE HOOSIER FIRE EQUIPMENT INC CHECK AMOUNT: $*******107.00* CARMEL, INDIANA 46032 4009 MONTDALE PARK DRIVE CHECK NUMBER: 241742 "�„i�oN .� VALPARAISO IN 46383 CHECK DATE: 02/03/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4237000 89341 107.00 REPAIR PARTS Page: 1 Invoice Hoosier Fire Equipment, Inc. Invoice Number: 0089341-IN 4009 Montdale Park Drive Invoice Date: 1/22/2015 Valparaiso,Indiana 46383 (219)462-1707 Order Number: 0116317 Order Date 12/24/2014 Salesperson: 0000 House Customer Number: CARM01 Sold To: Ship To: Carmel Fire Department Carmel Fire Department 2 Civic Square 2 Civic Square Carmel,IN 46032-7543 Carmel,IN 46032-7543 Confirm To: Customer P.O. Ship VIA F.O.B. Terms OUR DELIVERY SHIPPING POINT Net 10 Item Code Unit Ordered Shipped Back Ordered Price Amount /SORDER EACH 4.00 4.00 0.00 22.00 88.00 #P1747400 - SEAGRAVE INSTRUCTION LABEL Net Invoice: 88.00 Less Discount: 0.00 Freight: 19.00 Sales Tax: 0.00 Invoice Total: 107.00 VOUCHER NO. WARRANT NO. r ALLOWED 20 Hoosier Fire Equipment 1 IN SUM OF$ 4009 Montdale Park Drive Valparaiso, IN 46383 i $107.00 ON ACCOUNT OF APPROPRIATION FOR I Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1120 89341 42-370.00 $107.00 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 FEB 2 5. Fire Chief Title 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 o:Terms Date Due Invoice Invoice Description Amount Date. Number (or note attached invoice(s)or bill(s)) 89341 $107.00 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