250221 10/07/15 4�
". CITY OF CARMEL, INDIANA VENDOR: 369217
ONE CIVIC SQUARE GEAR WASH CHECK AMOUNT: $*******150.91
�. =4 CARMEL, INDIANA 46032 657 SOUTH 72ND STREET CHECK NUMBER: 250221
MILWAUKEE WI 53214 CHECK DATE: 10/07115
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350600 11197 150.91 CLEANING SERVICES
Gear wash Make checks payable to Gear Wash, LLC INVOICE
Invoice#: 11197
657 S. 72nd Street Invoice Date: 09/28/2015
Milwaukee,WI 53214 Invoice Terms: Net 30
Phone: 866-657-0111 Due Date: 10/28/2015
PO/Ref#: 24703
Fax: 414-918-4727
Organization: Carmel Fire Department
www.gearwash.com Exempt#:
BILL TO SHIP TO
Carmel Fire Department Carmel Fire Department
Gary Carter Gary Carter
2 Civic Square 2 Civic Square
Carmel, IN 46032 Carmel, IN 46032
317-571-2600 317-571-2600
ITEM ID DESCRIPTION OTY PRICE AMOUNT
Trouser Sys.ID: 1402597, Manf.: Honeywell, Model: LT041Z3Pl3, S/N:
1311005174, MDate: 11/12/2013, Name: MULFORD, PPE-ID:
ID# 55
FRT013 Repair-Trouser, Basic Patch, Premium OS, Each: RIGHT 1. $8.00 $8.00 T
POCKET
F0053 Option-Open/Close Seam for Repair, Each: RIGHT POCKET 1. $13.95 $13.95 T
FH011 Hardware-Grommet, Each: RIGHT POCKET 1. $5.65 $5.65 T
FRT014 Repair-Trouser, Basic Patch, Reinforcement Material, Each: 2. $10.05 $20.10 T
ARASHIELD
FRT014 Repair-Trouser, Basic Patch, Reinforcement Material, Each: 1. $10.05 $10.05 T
KEVLAR
FRT013 Repair-Trouser, Basic Patch, Premium OS, Each: 4. $8.00 $32.00 T
FO053 Option-Open/Close Seam for Repair, Each: 2. $13.95 $27.90 T
FRT003 Repair-Trouser, Seam Repair, Each: 2. $8.60 $17.20 T
Subtotal for 1402597 134.85
i
Thank you for your business. Sub-Total $134.85
Ship&Handling $16.06
TOTAL $150.91
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))
11197 $150.91
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
Gear Wash
IN SUM OF $
657 South 72nd Street
Milwaukee, WI 53214
$150.91
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 11197 43-506.00 $150.91 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
OCT - 2015
1
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund