HomeMy WebLinkAbout162360 08/07/2008 CITY OF CARMEL, INDIANA VENDOR: 131135 Page 1 of 1
e ONE CIVIC SQUARE HOOSIER FIRE EQUIPMENT INC CHECK AMOUNT: $149.45
CARMEL, INDIANA 46032 4009 MONTOALE PARK DRIVE
VALPARAISO IN 46383 CHECK NUMBER: 162360
CHECK DATE: 8/712008
DEP ACCOUNT PO NUMBER I NVOICE NU MBER AMOUNT DE
1120 4350900 T 68354 -IN 149.45 OTHER CONT SERVICES
I
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INVOICE PAGE: 1
Hoosier Fire Equipment, Inc. INVOICE NUMBER: 0068354 -IN
4009 Montdale Park Drive INVOICE DATE: 07/30/08
Valparaiso, Indiana 46383
ORDER NUMBER:
ORDER DATE:
(219) 462 -1707 SALESPERSON R. W. Pressel
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
UNITED PARCEL Net 10
ITEM NO. UNIT ORDERED SHIPPED BACK ORD PRICE AMOUNT
/SERVICE EACH 1.00 1.00 0.00 122.85 122.85
CUSTOMER'S 4.5 SCOTT AIR PAK REDUCER #00110068 PAK
ALERT #50589 REPAIRED AS PER ATTACHED
TAXABLE .00
NON TAXABLE 122.85
NET INVOICE: 122.85
SALES TAX: .00
FREIGHT: 26.60
INVOICE TOTAL: 149.45
1
HOOSIER FIRE EQUIPMENT, INC.
SCOTT 2.213.014.5 PAK ALERT REPAIR FORM
DATE: 07/24/2008 SHOP NUMBER: 465
CUSTOMER: Carmel Fire Department
2 Civic Square
Carmel, IN 46038
PRESSURE REDUCER PART SERIAL 00110068
REGULATOR PART SERIAL
PAK ALERT MODEL: SE: 1000: SERIAL
COMMENTS: Replaced Pak -Alert Board, Replaced Retaining Clip, Flow Tested.
PARTS INSTALLED
QTY. PART# DESCRIPTION PRICE
1 40015105 Pak Alert Board
1 31000380 Retaining Clip
2 9 Volt Batteries
ADDITIONAL PARTS ON BACK:
SCOTT POSI -CHEK 3 FLOW TEST: Yes
ADDITIONAL LABOR TIME: RATE:
TOTAL
SERVICE TECHNICIAN: Tom Roberts DATE COMPLETED: 07/24/2008
SCOTT PosiCheU 071241200811:58:32
PosiChek3 AM
scj Visual 1 Functional Test Results calibration was up
Scott Carmel Fire Dept to date when this
test was
L04628 Air-Pak 4.5 2 Civic Square performed.
Carmel Fire Dept Carmel In, 46038
Auxiliary IDs Functional Tests
Facepiece Facepiece Leak Test Pass 0.1 in. H2O
:Regulator tester :Exhalation Pressure Pass. 1. 8 i w.. H2O
Reducer 00110068 Remote Pressure Gauge Pass
Low
Pressure
1000 psi 2000 PSI 3000 PSI
Cylinder Pass 987 Pass 1967 Pass 3002
:A!dirW:AttaChment
Alarm(s) Activation Pass 1083 :PSI
Harness
Air Saver Switch Pass -4.0 in. H2O
Visual Inspection
,Static ..:Fac6iii6de:.:Pre��sure ;P
Facepiece Head Harness Pass
Primary Reducer Lockup Pass 99 PSI
86 affle arnes& aryk
Cylinder N/A
ass 1083 PSI 1 `PSI
Is S Low Cylinder Transfer Pr i P
:Secondary Rent
Hoses Pass Sec ondary Reducer Cree Pass 0 psi
mi 6�.
�Pift el�FbW]Tesf
High Pressure Leakage Pass 11 PSI
s
Pass econddr t':High�iEy���:� as
y::P�:: a j 1 1 5
Scott Air-Pak 4.5 Carmel Fire Dept 07124t20013 1111:513:32 AM Scott Air-Pak 4.5 Carmel Fire Dept 0712412008 11:58:32 AM
Standard Work Rate Maximum Work Rate (1 02 Liter Minute Vol.)
Hoosier Fire Equipment, Inc. 4 Hoosier Fire Equipment, Inc.
0
C11 C14
3 4009 Montdale Park Drive N 3-- 4009 Montdale Park Drive
2
/.9 /ON EN H A, A (17 ID 1 IS/ON
CL
,U
0-
Valparaiso, Indiana 46383 U
M Valparaiso, Indiana 46383
tL LL
0 1 000 2000 3000 40�00 5000 0 1000 2000 3000 4000 5dua
Supply Pressure PSI Supply Pressure PSI 71
[minimum Maximum Breathing Results Minimum Maximum
in H2O 2.1 in. H2O Pass Facepiece Pressure 0.9 in. H2O 2.4 in. H2O Pass
07/24/2008 12:09:00 PM Setup Technician Replaced Pak alert board, retainer clip, and new 9V batteries
Tested by Setup Technician f rY
Signatu,./,r,V1__, J CL
Service Center
EP Page 1 of 1 Version 3.22
Prescribed by State Board of Accounts Cary 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))
07/30/08 68354 -IN Repair SCBA $149.45
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
VOUCHER-NO. WARRANT NO.
ALLOWED 20
Hoosier Fire Equipment
IN SUM OF
4009 Montdale Park Drive
Valparaiso, IN 46383
$149.45
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 68354 -IN 43 -509-00 $149.45 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
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund