192106 11/23/2010 CITY OF CARMEL, INDIANA VENDOR: 131135 Page 1 of 1
0 ONE CIVIC SQUARE HOOSIER FIRE EQUIPMENT INC CHECK AMOUNT: $325.00
CARMEL, INDIANA 46032 4009 MONTDALE PARK DRIVE
'«off Ea VALPARAISO IN 46383 CHECK NUMBER: 192106
CHECK DATE: 11/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 0075709 325.00 AUTO REPAIR MAINTEN
INVOICE PAGE: 1
Hoosier Fire Equipment, Inc. INVOICE NUMBER: 0075709 -IN
4009 Montdale Park Drive INVOICE DATE: 11/10/10
Valparaiso, Indiana 46383
ORDER NUMBER:
ORDER DATE:
(219) 462 -1707 SALESPERSON House
CUSTOMER NO: CARM01
SOLD TO: SHIP TO:
Carmel Fire Department Carmel Fire Department
2 Civic Square 2 Civic Square
Carmel IN 46032 -7543 Carmel IN 46032 -7543
CONFIRM TO:
CUSTOMER P.O. SHIP VIA F.O.B TERMS
OUR DELIVERY Net 10
ITEM NO. UNIT ORDERED SHIPPED BACK ORD PRICE AMOUNT
/SERVICE EACH 1.00 1.00 0.00 325.00 325.00
CUSTOMER'S MODEL #HQT -C HOOSIER QUARTZ DYNA -LITE
INSTALLED NEW LIGHT HEAD AND REFURBISHED
TAXABLE .00
NON- TAXABLE 325.00
NET INVOICE: 325.00
SALES TAX: .00
FREIGHT: .00
INVOICE TOTAL: 325.00
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hoosier Fire Equipment
IN SUM OF
4009 Montdale Park Drive
I
Valparaiso, IN 46383
$325.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #(TITLE AMOUNT Board Members
1120 0075709 43- 510.00 $325.00 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
c
,r
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))
0075709 Repair Quartz Light $325.00
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