183781 03/29/2010 CITY OF CARMEL, INDIANA VENDOR: 354683 Page 1 of 1
s5 Q� ONE CIVIC SQUARE E M S A R INDIANA
a CARMEL, INDIANA 46032 6745 PAYNE ROAD CHECK AMOUNT: $512.00
INDIANAPOLIS IN 46203 CHECK NUMBER: 183781
CHECK DATE: 3/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 SI10359 512.00 OTHER CONT SERVICES
EM' SAR Indiana
6745 E. Payne Rd. Invoice
Indianapolis, IN 46203
(317) 788 -050 C ustomer Number Date Invoice Num
(31:7) 788 -85550 Fax IC1 005 2 2/ 20 10 51 -10359
Carmel Fire Department/24
f Carmel Fire Department/24
Carmel Fire Department 2 Civic Square Attn: j Carmel Fire Department
Accounts Payable 1 2 Civic Square r k
Carmel, IN 46032 Attn:
Carmel IN 46032
E j
Ship V Ter Due Dat Sa les Rep. Custome PO O riginal- Orde Number..:
UPS Ground Due o Receipt IW 2/8/2010
PM FERNO 4 0 4 PREVENTIVE MAINTENANCE 125.00 0 114 500.00
FERNO- WASHINGTON
MILEAGE 24 0 24 M-U,EAGE FF-,RNO- WASHINGTON EMS 0.50 0% 12.00
FERNO EMS
1 0 1 08700200 0 -00 0% 0.00
1 0 1 08700217 0 -00 0% 0.00
1 0 1 08700218 0.00 0% 0.00
1 0 1 08700219 0.00 0% 0.00
Total Item Count: 6 Total Items Shipped: 32
Subtotal: 512.00
Freight: 0.00
Tai:: 0.00
Total l 512. Q0
Amount Due: L 512.00
Page 1
VOUCHER NO. WARRANT NO.
ALLOWED 20
EMSAR Indiana
4 IN SUM OF
6745 Payne Road
Indianapolis, IN 46203
$512.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 SI -10359 43- 509.00 $512.00 I hereby certify that the attached invoice(s), or
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
LIAR 2 6 me
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
SI -10359 $512.00
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
Clerk- Treasurer