189759 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 079150 Page 1 of 1
ONE CIVIC SQUARE DONLEY SAFETY
CARMEL, INDIANA 46032 5546 ELMWOOD AVE CHECK AMOUNT: $16D.78
INDIANAPOLIS IN 46203
CHECK NUMBER: 189759
CHECK DATE: 9/1412010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 26632 160.78 REPAIR PARTS
L�
AM
i;ONL INVO
Please visit us on the web at www.donleysafety,corn
Phone 317- 786 -2268 Date Invoice
5546 Elmwood Ct. Fax 317 786 -2632
Indianapolis, IN 46203 5/19 26632
Bill To Ship To
CARMEL FIRE DEPARTMENT Bob VanVoorst
2 CIVIC SQUARE
CARMEL, IN 46032
USA
P.O. Number Terms Salesperson Ship Via F.O.B. I S.O.
NET30 GH UPS Ground Origin 99020
Ordered Shipped Bro Description Unit Price UOM Ext. Price
2 761680004 TANK STRAPS 76.54 153 -08
1 SHIPPING HANDLING 7.70 7.70
i
Sales Tax (7.0
PRICE DISCREPANCIES, RETURN REQUESTS OR Total $160.78
SHIPMENT ERRORS MUST BE REPORTED WITHIN 30
DAYS TO RECEIVE CREDIT.
Questions about this invoice? Please call 317 -786 -2268.
VOUCHER NO. WARRANT NO.
ALLOWED 20
Donley'Safety
IN SUM OF
5546 Elmwood Court
Indianapolis, IN 46203
$160.78
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 26632 42- 370.00 $160.78 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
SEPP 13 2090
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))
26632 $160.78
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