308995 03/07/17 (9, )
CITY OF CARMEL, INDIANA VENDOR: 357205
ONE CIVIC SQUARE H.O. BOSTROM CO, INC CHECKAMOUNT: S"""""""180.76"
CARMEL, INDIANA 46032 818 PROGRESS AVENUE CHECK NUMBER: 308995
WAUKESHA WI 53186 CHECK DATE: 03/07/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 195395 180.76 REPAIR PARTS
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H.O. Bostrom Co,. INC. Invoice Number: 195395
818 Progress Avenue
Waukesha,WI 53186 Page: 1 of 2
(262)542-0222 Date: 2/16/2017
(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$US Dollar
Pack Num:84945
CA02321
B Carmel Fire Dept S Carmel Fire Dept
I 2 Civic Square H 2 Civic Square
L Carmel IN 46032 I Carmel IN 46032
L USA P USA
T T
O O
Fax: 317-571-2615
er i s 1?utce Order; Packages Prepaid Weight Ship Via ; Terms
111115 --SEE BELOW-- 1 4.00 PS ET 30
LmeIR h, ` "Qty�Ordered Y, Qty Shipped Back Order Unit`Pride Extended Price
1 2.000 2.000 0.000 33.47000 66.94
Cl:
Item: 8902-119
Description: KIT BOLSTER CVRS ABS NON-ABTS TKR
U/M: EA
Date Shipped: 2/16/2017
2 3.000 3.000 0.000 37.94000 113.82
Cl:
Item: 8920-068
Description: KIT VALVE CUP MOLDED ABS SAFETY
H.O. Bostrom Co,. INC.
818 Progress Avenue Invoice Number: 195395
Waukesha,WI 53186 Page: 2 of 2
• (262)542-0222 Date: 2/16/2017
(262)542-3784-FAX
sales®hobostrom.com Salesperson:
' Regular Invoice
"Tell us how we can serve you better" Fein No.:39-1212995
Fein No.:
Currency:US$US Dollar
Pack Num:84945
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
rde Purchase:Order Packages Prepaid Weight Ship Via Terms
111115 --SEE BELOW-- 1 4.00 S INET 30
Line f e�� ;Qty Ordered Qty Shipped ; Back Order Unit Price Extended Price
U/M: EA
Date Shipped: 2/16/2017
3 1.000 1.000 0.000 37.94000 37.94
Cl:
Item: 8920-068
Description: KIT VALVE CUP MOLDED ABS SAFETY
U/M: EA
Date Shipped: 2/16/2017
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 Sales Amduntll 218.70
WAUKESHA,WI 53186 Misc Charges -37.94
Freight 0.00
Insurance 0.00
Sales Tax 0.00
Prepaid Amount 0.00
Total 180.76
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
I8%).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.