334045 01/04/19 CITY OF CARMEL, INDIANA VENDOR: 365283
ONE CIVIC SQUARE FIRE SERVICE INC CHECK AMOUNT: $*****1,295.00*
CARMEL, INDIANA 46032 9545 N INDUSTRIAL DR CHECK NUMBER: 334045
ST JOHN IN 46373 CHECK DATE: 01/04/19
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 R4467099 102118 47272 1,295.00 MANIKINS: RUTH AND RA
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 365283 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
FIRE SERVICE INC IN SUM OF$ CITY OF CARMEL
9545 N INDUSTRIAL DR 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.
ST JOHN, IN 46373
Payee
$1,295.00
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
102118 47272 44-670.99 $1,295.00 1 hereby certify that the attached invoice(s),or 12/20/18 47272 Manikins $1,295.00
1120 Encumbered 102 Prior Year 1120 102
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
Thursday, January 3,2019
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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
����"'�' Invoice
9545 N. Industrial Dr.
St. John, IN 46373 Date Invoice#
Federal ID#35-1834214 12/20/2018 47272
Phone#(219)365-7157 Fax#(219)365-8572
Bill To Ship To
City of Carmel City of Carmel Fire Dept.
One Civic Square 2 Civic Square
Carmel,IN 46032 Carmel,IN 46032
S.O. No. P.O. No. Terms Due Date Rep
JM 111618-83 102118 12/20/2018 JMM
Item Description Ordered Invoiced Rate Amount.
RT-2395001050 Ruth Lee Manikin, 100 Pound 1 1 705.00 705.00
RT-2395001020 F&R Duty Manikin-GEN2 Youth(44lbs) 1 1 465.00 _ 465.00
Inbound Freight Inbound Freight 1 125.00 125.00
2%Interest Per Month On All Past Due Account Over 30 Days Old Plus Any Legal Fee Due
To Legal Action Total $1,295.00
Payments/Credits $0.00
Balance Due $1,295.00