313797 7/18/2017 ��B`•� CITY OF CARMEL, INDIANA VENDOR: 357205
�': CHECK AMOUNT: $***...**95.95
ONE CIVIC SQUARE H.O. BOSTROM CO, INC
43 �, CARMEL, INDIANA 46032 818 PROGRESS AVENUE CHECK NUMBER: 313797
� WAUKESHA WI 53186 CHECK DATE: 07/18/17
M�TUN
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 198020 95.95 REPAIR PARTS
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H.O. Bostrom Co,I. INC.
818 Progress Avenue Invoice Number: 198020
Waukesha,WI 53186 Page: 1 of l
• (262)542-0222 Date: 6/27/2017
(262)542-3784-FAX
sales@hobostrom.com Salesperson:
Regular Invoice
"Tell us how we can serve you better" Fein No.:39-1212995
Fein No.:
Currency: US$US Dollar
Pack Num: 87493
CA02321
B Carmel Fire Dept S Carmel Fire Dept
I 2 Civic Square H 2 Civic Square
L Carmel IN 46032 1 Carmel IN 46032
L USA P USA
T T
U O
Fax: 317-571-2615
Order I Purchase Order Packages Prepaid Weight Ship Via Terms
113762 Bob 6/13/17 1 3.00 PS ET 30
Line/Rel Qty Ordered Qty Shipped Back Order I Unit Price Extended Price
1 1.000 1.000 0.000 76.41000 76.41
Cl:
Item: 8024-1804
Description: KIT C/P BOLST LH 400S DURA BLK
U/M: EA
Date Shipped: 6/27/2017
Tax Basis Summar Tax Rate: Tax Basis Extended Tax
Tax Code: N Taxable: 0.00 0.00 0.00
PLEASE REMIT TO:
H.O. BOSTROM Co., INC.
818 PROGRESS AVENUE I Sales Amount 76.41
WAUKESHA, WI 53186 Misc Charges 0.00
Freight 19.54
Insurance 0.00
Sales Tax 0.00
Prepaid Amount 0.00
Total 95.95
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 vAll be assessed on each checkis)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 attorney's 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.