244331 4 /15/2015 ' 1y ur-CAp�f'
�• CITY OF CARMEL, INDIANA VENDOR: 273975
ONE CIVIC SQUARE ROBERT'S DISTRIBUTORS, INC CHECK AMOUNT: $********24.99*
CARMEL, INDIANA 46032 220 E ST CLAIR ST CHECK NUMBER: 244331
INDIANAPOLIS IN 46204 CHECK DATE: 04/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 1292060 24.99 REPAIR PARTS
o FILM
Invoice
Page: 1
ROBERTS CARMEL Ticket#: 5-1292060
12761 OLD MERIDIAN ST Ticket date: 4/10/15
CARMEL, IN 46032
01
317-818-9800 Fax 317-818-1400 FE4 32-0000112 Station: 5
Orig ord#: 5-1-1
292060
Sold to: CARMEL FIRE DEPT Ship to:
2 CIVIL SQUARE
CARMEL, IN 46032
571-2600
DENISE
Customer-#: CAFD Ship date: Purchase Order-#: Ship-via code:
Sis rep: 72 Location: 5 Terms: NET 10 DAYS
w
Quantity Item# Description ; Manuf Part# 77-777
Pnce Unit flag ;ext prc
I
1 HOO-02200 HOO-H LINE SDHC 16GB 61 H1016 24.99 EACH 24.99
1 NOTE keith freer 0.00 EACH 0.00
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Pa menta. n
y as i
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T s 9
Drawer: 501 User: 53 Total line items: 2 Sub Total: 24,99
Tax: 0.00
Total: 24.99
Tax: 0.00
Authorized Signature:
PLEASE PAY FROM THIS INVOICE
We Appreciate Your Business
Please REMIT to: 220 E. St. Clair St. Indianapolis, IN 46204 TOTAL: 24.99
VOUCHER NO. WARRANT NO.
ALLOWED 20
Roberts Distributors
IN SUM OF$
220 E. St. Clair St.
Indianapolis, IN 46204
$24.99
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
1120 1292060 42-370.00 $24.99 1 hereby certify that the attached invoice(s), or
I
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
APR 1 3 201.5
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
p CITY OF CARMEL
I
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.
I
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
1292060 $24.99
I
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