244349 4 /15/2015 4• CITY OF CARMEL, INDIANA VENDOR: 294850
ONE CIVIC SQUARE STOOPS FREIGHTLINER CHECK AMOUNT: $*r..r.••79.20'
;: =q; CARMEL, INDIANA 46032 27825 NETWORK PLACE CHECK NUMBER: 244349
+�,�,_- �- CHICAGO IL 60673-1278 CHECK DATE: 04/15/15
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 X30103503701 79.20 REPAIR PARTS
INVOICE NO. X301035037:01
INVOICE DATE 03/30/2015
P.O. NUMBER • PSU345
FREIGHTLINER-QUALITY TRAILERSHIP VIA DELIVERY
DIVISIDN Of TRUC(n�aUNTB' REFERENCE
TRUCK COUNTRY- INDIANAPOLIS
1851 W THOMPSON ROAD
ALLCLAIMSANORETU,RJEDGOOpSMUST,BEACCOMPANIED"BYTHISINUOICE INDIANAPOLIS, IN 46217
NORETURNSONELECTRICALORSPECIALOR66R"TS NO RETURNSWITHOUTTHIS Phone: (800)899-1533 FAX:;(317)781-4370
INVOICE NO RETURNS AFTER 30 PAYS 10%RE STOCK.CHARGE ON ALL RETUf�NEp
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.X301035037:01
DATE SHIPPED TERMS SALESPERSON WRITER SHIP VIA UNIT ID VIN
3/30/2015 CHG S1617
QTY QTY UNIT EXT
SHIP B/O ITEM DESCRIPTION BIN 1 PRICE PRICE
,r
1 0 301 F/680 820 00 20 `' --LAMP ASSY-TURN SIGNAL,FRONT U10 59.25 59.25
0, 0 C PLEASE SHIP UPS GROUND TO 0.00 0.00
ADDRESS SHOWN
1 0 FRT FREIGHT OUT 19:95 19.95
b
X
a _
SALES TAX EXEMPTION CERTIFICATEDISCLAIMER OF WARRANTIES
I certify that this transaction is exempt from the Indlana Sales Tax because: ANY WARRANTIES ON THE PRODUCTS SOLD HEREBY ARETHOSE MADE
L,
Purchaser Is a common wntracl Carrier who will use Items purchased Gr seryl d � BY,"NUFACTURER,IF ANY.THE SELLER HEREBY EXPRESSLY'" Subtotal 79.20
exclusively as such Carrier. DISCLAIMS ALL WARRANTIES EITHER EXPREsS,okwPIJED INCLUDING
ANY /�
IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A TAX 0.00
Authority Number: PARTICULAR PURPOSE,AND TRUCK COUNT RY:OFhid iana NEITHER
Purchaser is engaged in the business of and items will be used for msale, ASSUMES NORAUTHORIZES ANY OTHER PERSON TO ASSUME FOR IT ANY
LIABILITY IN CONNECTION WITHTHE SALE OF SAID PRODUCTS WE TaXDeS2 0.00
Resale Number: HEREBY CERTIFY THAT THESEiGOODS WERE PRODUCED IN COMPLIANCE
WITH ALLAPPLICABLE REQUIREMENTS OF SECTIONS 6,7 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: 79.20
DIVISION ISSUED UNDER SECTION 14 THEREOF.TRUCK COUNTRY DOES
EXPRESS A LIMITED NON-TRANSFERRABLE WARRANTY,TO THE ORIGINAL
Business Name 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%%)PER MONTH IS APPLIED TO ALL
ACCOUNTS 30 DAYS PAST DUE.THIS EQUALS AN ANNUAL PERCENTAGE '
Business Address Date 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 BY THE CUSTOMER OR CUSTOMER REPRESENTATIVE CONSTITUTES AGREEMENT TO PAY REASONABLE LEGAL EI(PENCES,
INLCUUING ATTORNEY AND COUNT COSTS INCURRED BY TRUCK COUNTRY FOR PAYMENT OF THIS INVOICE.
CUSTOMER SIGNED COPY Page 1 of 1
MAIL COPY WILL BE SENT
VOUCHER NO. WARRANT NO.
ALLOWED 20
Stoops Freightliner
IN SUM OF$
27825 Network Place
Chicago, IL 60673-1278
$79.20
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 X301035037:01 42-370.00 $79.20 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
APR 1 3 2015
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
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
X301035037:01 TSU 345 $79.20
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