197153 05/11/2011 CITY OF CARMEL, INDIANA VENDOR: 079150 Page 1 of 1
ONE CIVIC SQUARE DONLEY SAFETY CHECK AMOUNT: $771.00
CARMEL, INDIANA 46032 5546 ELMWOOD AVE
INDIANAPOLIS IN 46203 CHECK NUMBER: 197153
CHECK DATE: 5/11/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 W1757 771.00 AUTO REPAIR MAINTEN
�tEY
Please visit us on the web at Hww.donleysatety.com Invoke
Phone 317.786 -2268 Date Invoice
5546 Elmwood Ct. Fax 317 -766 -2632
Indianapolis, IN 46203
4/25/2011 W1757
Bill To Service Info
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL, IN 46032 CARMEL, IN. 46032
USA
S.O. No. Terms Rep Vehicle Mileage VIN Customer P.O.
Due on receipt FS A -40 101144 3HTMNAA1.13N585817
Item Quantity Description Rate UOM Amount
LABOR 7 REPLACE CAB TO BOX BELLOWS 85.00 LABOR HRS 595.00
04340006 20 SEAL, BELLOWS, ACCORDIAN STYLE 5.23 104.60
SHOP 1 MISC. SHOP SUPPLIES, CLEANING 71.40 71.40
SUPPLIES, ETC.
Sales Tax (7.0 $0.00
PRICE DISCREPANCIES, RETURN REQUESTS OR Total $771.00
SHIPMENT ERRORS MUST BE REPORTED WITHIN
30 DAYS TO RECEIVE CREDIT. If you have questions
about this invoice, Please call Debra O'Dair
317- 786 -2268 or email to dodair @donleysafety.com
VOUCHER NO. WARRANT NO.
ALLOWED 20
Donley Safety
IN SUM OF
5546 Elmwood Court
Indianapolis, IN 46203
$771.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# I Dept- INVOICE NO- ACCT /TITLE AMOUNT Board Members
1120 I W1757 I 43- 510.00 I $771.00 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
M4 79,2011
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))
W1 757 A40 $771.00
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