185223 05/11/2010 CITY OF CARMEL, INDIANA VENDOR: 354683 Page 1 of 1
ONE CIVIC SQUARE E M S A R INDIANA 4 6745 PAYNE ROAD CHECK AMOUNT: $95.00
CARMEL, INDIANA 46032 C
INDIANAPOLIS IN 46203 HECK NUMBER: 185223
IoM
CHECK DATE: 5/11/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 SI -10398 95.00 REPAIR PARTS
I EIVISAR Indiana
0745 Payne Rd. Invoice Indianapolis, IN 46203
(317) 697 -0510
(317) 788 -8550 Fax C ustomer Number Date invoice Number
�CI0052 X4/20/2010 SI1.0398
a
Carmel F
ire Department/24 Cannel Fire Depanment/24
Carmel Fire Department 2 Civic Square Attn: !Carmel Fire Department
j Accounts Payable I 2 Civic Square
Carmel, IN 46032 Attn:
I Carmel, IN 46032
Ship Via 'Perms Due Date Sales Rep Custome Ori ginal Order Number I
UPS Ground Net 30 5/20/2010
1 Refurbished 175
95.00 0% 95.40
Total Item Count: 1 Total Items Shipped: t
SubtotaL 95.OU
Freight:! 0.00i
TaxJ 0.00
Total: 95.00)
i 1 1
Amount Due: 95.00
Page i
VOUCHER NO. WARRANT NO.
ALLOWED 20
EMSAR Indiana
IN SUM OF
6745 Payne Road
Indianapolis, IN 46203
$95.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 SI- 10398 42- 370.00 $95.00 1 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
MAY 10 2010
e v U o
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 -10398 $95.00
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