250734 10/21/15 9,Coq .
�� .�f CITY OF CARMEL, INDIANA VENDOR: 358389
® ONE CIVIC SQUARE JACK DOHENY SUPPLIES INC CHECK AMOUNT: $***'***550.00'
r° CARMEL, INDIANA 46032 PO BOX 609 CHECK NUMBER: 250734
,,_TON,�� NORTHVILLEMI 48167 CHECK DATE: 10/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4353099 H71506 550.00 OTHER RENTAL & LEASES
Remittance Address:
Jack Doheny Companies, Inc. J��k®�h�� Phone(248)349-0904
P.O. Box 609 Fax (248)349-2774
Northville, Michigan 48167 COMPANIESAF www.DohenyCompanies.com
Customer I N V O I C E Invoice Pg
CARME01 H71506 1
Document
R22224 10/09/15
Sold To Ship To
CITY OF CARMEL STREET DEPT. CITY OF CARMEL STREET DEPT.
3400 WEST 131ST STREET JOBSITE :
WESTFIELD IN 46074 WESTFIELD IN 46074
FOB JDC WHITESTOWN IN FACILITY
------------------------- ---- -------------- -------- --- ---- ---- ---------------- --
Br Trk Make Model Serial Equipment Meter Sls Customer P.O.
-------------------- ------ - ---- ----- -- ---- ----- --- --- --- --- - --------------------
007 DD
----------------------------- ------ -------------------- --------------------- ----
Ordr Ship Description List Each Amount
----------------------- -- --- ----- ---------------------- ---------------- ---------
Taken By TONYA SMITH
Rental Contract R22224
Period: 10/07/15 Thru 10/09/15
1 1 MC 000010843 CCU208 PCU-0089 S 550 . 00 550 . 00
CAMERA CONTROL UNIT
Hours : 16 . 00
The Following Attachments Are Included:
REEL
Hours : 16 . 00
656 ' MULTI-CONDUCTOR CABLE
Hours : 16 . 00
6-WHEEL STEERABLE CRAWLER
Hours : 16 . 00
PAN&TILT CAMERA
Hours : 16 . 00
BATTERY PACK
Hours : 16 . 00
RENTAL START DATE : 10-8-2015
RENTAL END DATE : 10-9-2015
INDIANA MUNICIPALITIES . 00
0031201550
-------------------- ------ ---- ---- -- --- - ---- - ---- -- ------- ------------- ---------
CONTINUED
SEE REVERSE SIDE FOR SALE TERMS AND CONDITIONS
Remittance Address:
Jack Doheny Companies, Inc. J��k®®h�� Phone (248)349-0904
P.O. Box 609 Fax (248)349-2774
Northville, Michigan 48167 COMPANIESAF www.DohenyCompanies.com
Customer I N V O I C E Invoice Pg
CARME01 H71506 2
Document
R22224 10/09/15
Sold To Ship To
CITY OF CARMEL STREET DEPT. CITY OF CARMEL STREET DEPT.
3400 WEST 131ST STREET JOBSITE:
WESTFIELD IN 46074 WESTFIELD IN 46074
FOB JDC WHITESTOWN IN FACILITY
------------- ---------- --- ------------------------- ---- ----- - --------------- ----
Br Trk Make Model Serial Equipment Meter Sls Customer P.O.
---------------------- --- --- ------- - ------ ------- ---- ----- ------ ----------------
007 DD
----------------------- ---- ---- - ------------------------- ------- ----------------
Ordr Ship Description List Each Amount
------------------- ---- --- ------------------------------- -----------------------
PLEASE NOTE: FAX ALL IFTA MILEAGE LOGS AND
FUEL RECEIPTS TO (248) 374-4259
-------------------- ----- --- ------------ - -- - -- - -------- ------ - ------------------
Total 550 . 00
---------- - ---------- ---- ------- ------- - --- - --- --- --- ----- - ---------------------
SEE REVERSE SIDE FOR SALE TERMS AND CONDITIONS
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))
10/09/15 H71506 $550.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Jack Doheney Supplies
IN SUM OF $
P. O. Box 609
Northville, MI 48167
$550.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
2201 1 H71506 1 43-530.991 $550.00 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
r
/
/Friday,/ cttober 16, 2015
/ 1 Pr s n . A
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