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Home My WebLink About305575 11/28/16 CITY OF CARMEL, INDIANA VENDOR: 357205 .j; i,• ONE CIVIC SQUARE H.O. BOSTROM CO, INC CHECK AMOUNT: $*******910.31* CARMEL, INDIANA 46032 818 PROGRESS AVENUE CHECK NUMBER: 305575 M�inn_�D. WAUKESHA WI 53186 CHECK DATE: 11/28/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4351000 193679 910.31 AUTO REPAIR & MAINTEN VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) H.O. BOSTROM CO, INC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 549 IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service KENOSHA, WI 53141-0549 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $910.31 Payee Purchase Order# ON ACCOUNT OF APPROPRIATION FOR 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 193679 43-510.00 $910.31 1 hereby certify that the attached invoice(s),or 11/21/16 193679 $910.31 1120 101 1120 101 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Monday, November 21,2016 David Haboush Fire Chief I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 ,20— Cost 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer H.O. Bostrom Co,. INC. 818 Progress Avenue Invoice Number: 193679 Waukesha,WI 53186 Page: 1 of 4 (262)542.0222 Date: 11/11/2016 (262)542-3784-FAX / sales@hobostrom.com Salesperson: Regular Invoice "Tell us how we can serve you better" Fein No.:39-1212995 Fein No.: Currency:US$US Dollar Pack Num:83264 CA02321 B Carmel Fire Dept S Carmel Fire Dept I 2 Civic Square H 2 Civic Square L Carmel IN 46032 I Carmel IN 46032 L USA P USA T T O O Fax: 317-571-2615 'Order'.. Purchase Order' Packages ,?Prepaid Weight' ' " " Ship Via';,' Terms ?. 109450 --SEE BELOW-- 23.0 UPS ET 30 Line/Rel ,,Qty Ordered ° _ Qty Shipped Back Order Unit;;.Price" ;. Extended Price,, ,• 1 2.000 2.000 0.000 200.29000 400.58 Cl: Item: 8060-0961 CH 1 Description: KIT C/P S T-350 FCR LO SEAM SH1 BLK DURA U/M: EA Date Shipped: 11/11/2016 1800 2 2.000 2.000 0.000 68.83000 137.66 CI: Item: 8016-3447C Description: KIT-CVR S-FX SEAGRAVE BLK DURA - -- - - -- strom H.O. BoessAv Co,. INC. Invoice Number: 193679 818 Progress Avenue Waukesha,WI 53186 Page: 2 of 4 f"Tell (262)542.0222 Date: 11/11/2016 (262)542-3784-FAXsales®hobostrom.comSalesperson: Regular Invoice us how we can serve you better" Fein No.:39-1212995 Fein No.: Currency:US$US Dollar Pack Num:83264 CA02321 B Carmel Fire Dept S Carmel Fire Dept I 2 Civic Square H 2 Civic Square L Carmel IN 46032 I Carmel IN 46032 L USA P USA T T O O Fax: 317-571-2615 '.Order ,- Purchase Order' . .Packages Prepaid, Weight Ship Via° ;` .`• Terms 109450 --SEE BELOW I 23.0 UPS INET 30 Lirie/ReI Qty Ordered : `Qty Shipped Back Order'. Unit Price. Extended Price`' U/M: EA Date Shipped: 11/11/2016 3 2.000 2.000 0.000 71.09000 142.18 CI: Item: 8902-006SH 1 Description: KIT FOAM S SIERRA W/SH1 U/M: EA Date Shipped: 11/11/2016 H.O. Bostrom Co,. INC. 818 Progress Avenue Invoice Number: 193679 Waukesha,WI 53186 Page: 3 of 4 f"Tetl (262)542-0222 Date: 11/11/2016 (262)542-3784-FAX sales@hobostrom.com Salesperson: Regular Invoice us how we can serve you better" Fein No.:39-1212995 Fein No.: Currency:US$US Dollar Pack Num:83264 CA02321 B Carmel Fire Dept S Carmel Fire Dept I 2 Civic Square H 2 Civic Square L Carmel IN 46032 I Carmel IN 46032 L USA P USA T T O O Fax: 317-571-2615 Order: Purchase Order Packages Prepaid' Weight'' Ship Via Terms ' 109450 --SEE BELOW-- 23.0 UPS NET 30 Line/Rel Qty Ordered Shi QtYpp ed Back Order: Unit=Price Ektended Price 4 1.000 1.000 0.000 39.22000 39.22 Cl: Item: 8920-080 Description: KIT VALVE SCOTT BOTTLE DIAMOND SHAPE U/M: EA Date Shipped: 11/11/2016 5 2.000 2.000 0.000 60.78000 121.56 Cl: Item: 8902-116 Description: KIT SEAT SWITCH SH1 J H.O. Bostrom Co,. INC. Invoice Number: 193679 818 Progress Avenue Waukesha,WI 53186 Page: 4 of 4 i . (262)542-0222Date: 11/11/2016 } (262)542-3784-FAX Salesperson: sales@hobostrom.com ` • Regular Invoice "Tell us how we can serve you better" Fein No.:39-1212995 Fein No.: Currency:US$US Dollar Pack Num:83264 CA02321 B Carmel Fire Dept S Carmel Fire Dept I 2 Civic Square H 2 Civic Square L Carmel IN 46032 I Carmel IN 46032 L USA P USA T T O O Fax: 317-571-2615 Order Purchase Order. Packages Prepaid' - Weight : Ship Via 109450 --SEE BELOW I I 23.0 UPS INET 30 Pne/Rel I Qty Ordered Qty Shipped _ "",,"Back Order Unit"Price ,-`_Extend6d Price: U/M: EA Date Shipped: 11/11/2016 Tax Basis Summary Tax Rate: Tax Basis Extended Tax Tax Code: NT Taxable: 0.00 0.00 0.00 PLEASE REMIT TO: H.O. BOSTROM Co., INC. 818 PROGRESS AVENUE ales"Ainount 841.20 WAUKESHA, WI 53186 Misc Charges 0.00 Freight 69.11 Insurance 0.00 Sales Tax 0.00 Prepaid Amount 0.00 .Total 910.31 Meeting All Your Seating Needs Since 1946 'Credit availability,extension or continuation shall be in the sole discretion of H.O.Bostrom Co.,Inc. Past Due Accounts are subject to 1.5%Monthly FINANCE CHARGE(APR 18%).A$40.00 service charge will be assessed on each check(s)returned from our bank,unpaid,for any reason. In the event the account is turned over to an attorney or collection agency(or both)for collection,or suit is brought on same,purchaser shall pay all reasonable attorneys fees,courts costs and collection fees incurred by H.O. Bostrom Co.,Inc.' Return Goods: Restocking charge will apply to all returns. Return Material Authorization (RMA#) must be requested prior to returning any material.