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193043 12/22/2010 CITY OF CARMEL, INDIANA VENDOR: 030130 Page 1 of 1 ONE CIVIC SQUARE BROWN EQUIPMENT CO., INC CARMEL, INDIANA 46032 PO Box 9799 CHECK AMOUNT: $336.50 FT WAYNE IN 46899 -9799 CHECK NUMBER: 193043 CHECK DATE: 12/22/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4237000 20445 336.50 REPAIR PARTS Brown Equipment Co., Inc. Invoice 20445 P O Box 9799 Date 12i9/2010 Fort Wayne, M 46899 -9799 Phone 260( 747 -2312 Bill To Ship To CARMEL STREET DEPT. CARMF' STREE "l' DEPT. 3400 W. 131 ST STREET 3400 W. 131 ST STREET WESTFIELD, IN 46074 WESTFIELD. IN 46074 Packing List P.O. Number Terms Salesperson Ship Date Ship Via 4019 JEFF NET 10 JOE 12/9/2010 UPS Quantity Item Code Description Price Each Amount 1 15917 -1 EXTEINSION HOSE 326.49 326.49 1 FREIGHT 10.01 10.01 Sales Tax (7.0 0.00 Total $336.50 V NO. WARRANT NO. ALLOWED 20 Brown Equipment Co. Inc. IN SUM OF P. O. Box 9799 Fort Wayne, IN 46899 -9799 $336.50 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO Dept. INVOICE= NO. ACCT #!TITLE AMOUNT Board Members 2201 20445 42- 370.00 $336.50 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 Thursday, D6 ccember 16, 2010 f� i Street Commissioner Street 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)) 12/09/10 20445 $336.50 1 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 1 20 Clerk- Treasurer