HomeMy WebLinkAbout260173 06/28/16 ,+ui..Cqq*f
�;/ �. CITY OF CARMEL, INDIANA VENDOR: 00351391
`: CHECK AMOUNT: $*"`"*"277.00*
.; ® �j•: ONE CIVIC SQUARE GEAR GRID
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CARMEL, INDIANA 46032 670 SW 15TH STREET CHECK NUMBER: 260173
�'�iGoN FOREST LAKE MN 55025 CHECK DATE: 06/28/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 0012756-IN 277.00 REPAIR PARTS
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
GEAR GRID ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
670 SW 15TH STREET IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
FOREST LAKE, MN 55025 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$277.00 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Carmel Fire Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
12756-IN 42-370.00 $277.00 1 hereby certify that the attached invoice(s),or 6/20/16 12756-IN $277.00
1120 101 1120 101
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday,June 20,2016
David Haboush
Fire Chief
I hereby certify that the attached invoice(s),or bill(s), is(are)true and correct and I have
audited same in accordance with IC 5-11-10-1.6
, 20—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
` ,I -A� - AS ! -�� Invoice Invoice Number: 0012756-IN
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Invoice Date: 6/10/2016
Geal-Grid Corporation
670 15th St SW Order Number: 0017122
Forest Lake, MN 55025 Customer PO:
Phone: (651)464-4468 Fax: (651)464-4780
Customer Number: 01-0000065
www.geargridcorp.com
Federal ID M 41-1690616
GSA M
Bill To: Ship To: ,
Carmel Fire Dept Carmel Fire Dept
2 Civic Square FS#41-Headquarters
Carmel, IN 46032 2 Civic Dr
Carmel, IN 46032
Bill to Contact: Ship to Contact:
Denise Snyder
Phone: (317)571-2622 Phone:
Ship Date Ship Via F.O.B. Terms
6/8/2019 Fed Ex Net 30
Pro M
Qty. Qty. Qty.
Line Part Number&Description Ordered Shipped Backordered Price Ext.Amount
0001 402094 2-Start-20" 2 2 0 30.00 60.00
Color: Red Baron
0002 402093 2-Ext-20" 4 4 0 30.00 120.00
Color: Red Baron
Net Invoice: 180.00
Less Discount: 0.00
Freight: 97.00
Sales Tax: 0.00
Invoice Total US$: 277.00
Less Down Payment: 0.00
Invoice Balance US$: 277.00
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