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157508 03/19/2008 CITY OF CARMEL, INDIANA VENDOR: 131135 Page 1 of 1 ONE CIVIC SQUARE HOOSIER FIRE EQUIPMENT INC i d CHECK AMOUNT: $638.00 CARMEL INDIANA 46032 4009 MONTDALE PARK DRIVE VALPARAISO IN 46383 CHECK NUMBER: 157508 CHECK DATE: 3/1912008 DEP ARTMENT ACCOUNT PO NUM INVOICE NUMB AMOUNT DESCRIPTION 1120 4350900 0067055 -IN 638.00 OTHER CONT SERVICES INVOICE PAGE: 1 Hoosier Fire Equipment, Inc. INVOICE NUMBER: 0067055 -IN 4009 Montdale Park Drive INVOICE DATE: 02/29/08 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 OUR DELIVERY Net 10 ITEM NO. UNIT ORDERED SHIPPED BACK ORD PRICE AMOUNT /SERVICE EACH 1.00 1.00 0.00 36.00 36.00 CUSTOMER'S 45 SCOTT AIRCLINDER VE +VS +R /SERVICE EACH 1.00 1.00 0.00 142.65 142.65 CUSTOMER'S EZ FLO SCOTT REGULATOR SERIAL #NJ0013136EZVQ REPAIRED AS PER ATTACHED /SERVICE EACH 1.00 1.00 0.00 359.35 359.35 CUSTOMER'S 4.5 SCOTT AIR PAK SERIAL #00110108 REPAIRED AS PER ATTACHED /PARTS LOT 1.00 1.00 0.00 100.00 100.00 MISCELLANEOUS PARTS INSTALLED TAXABLE .00 NON TAXABLE 638.00 NET INVOICE: 638.00 SALES TAX: .00 FREIGHT: .00 INVOICE TOTAL: 638.00 HOOSIER FIRE EQUIPMENT, INC. SCOTT 2.213.014.5 PAK ALERT REPAIR FORM DATE: 02 -22 -2008 SHOP NUMBER: 116 #2A CUSTOMER: Carmel Fire Department 2 Civic Square Carmel, IN 46032 PRESSURE REDUCER PART #802220 -03 SERIAL 00110108 REGULATOR PART SERIAL P AK ALERT MODEL: SE: X 1000: S ERIAL 50632 COMMENTS: Replaced broken cylinder retention latch and "Buddy" hose regulator holder PARTS INSTALLED QTY, PART# DESCRIPTION PRICE 1 804335 -04 Hose 1 10008880 Regulator Holder ADDITIONAL PARTS ON BACK: N SCOTT POSI -CHEK 3 FLOW TEST: Y ADDITIONAL LABOR TIME: .8 RATE: TOTAL SERVICE TECHNICIAN: RANDY HERMA DATE COMPLETED: 02 -22 -2008 HOOSIER FIRE EQUIPMENT, INC. SCOTT 2.2/3.014.5 PAK ALERT REPAIR FORM DATE: 02 -22 -2008 SHOP NUMBER: 116 #1 CUSTOMER: Carmel Fire Department 2 Civic Square Carmel, IN 46032 PRESSURE REDUCER PART SERIAL REGULATOR PART 804370 -02 SERIAL #NJ0013136EZVQ PAK ALERT MODEL: SE: X 1000: SERIAL 50820 COMMENTS: Evaluated replaced Diaphragm and Flow tested PARTS INSTALLED QTY. PART# DESCRIPTION PRICE 1 803792 -01 Diaphragm ADDITIONAL PARTS ON BACK: N SCOTT POSI -CHEK 3 FLOW TEST: Y ADDITIONAL LABOR TIME: .5 RATE: TOTAL SERVICE TECHNICIAN: RANDY HERMA DATE COMPLETED: 02 -22 -2008 scirrT SCOTT PosiChek3 021221200812:01:44 Visual 1 Functional Test Results PosiChek3 PM calibration was up Scott CARMEL FD to date when this Air -Pak 4.5 2 CIVIC SQUARE test was L02005 performed. CARMEL 6048 CARMEL, IN 46032 Apparatus Tested Functional Tests Location CFD Facepiece Leak Test Pass 0.1 in. H2O Other ID 15xhaifiar� Pressure :..Pass 1 gin H2a Auxiliary IDS Remote Pressure Gauge Facepiece Martin, Dave 1000 PSI 2000 PSI Regtrlatot N�30t7131362 VQ Pass 1076 Pass 2010 Reducer 00110108 Ldw Pressure A[a!rm Alarm(s) Activation Pass 1101 PSI Alt Savet Switch Pass 3 9 tip H2O. Cylinder 4irlin� Attachment Static Facepiece Pressure Pass 1.1 in H2O 4'rtmary Retliacer Lockup Pass 95 PSI Harness Visual Inspection Primary Creep Pass 2 PSI Facepiece /Head Harness Pass otnr Gyllnder ]'ranst Pr Pass ,:,1101.' f'SI RR trarrte�r7Gss Pass Secondary Reducer Lockup Pass 153 PSI Cylinder NIA Secondary ReducerCrelp Pass 0 PSI P,larrns Purge Flow Test Pass 211 Umm Vass Fllgil Press0re'Leakage Pass O :PSI Hoses Pass Secondary Pr. at High Cyl. Pass 150 PSI Scott Air -Pak 4.5 -CARMEL 6048 02122QO0812:01:44 P M Scott Air -Pak 4.5 CARMEL 6048 02122200812:01:44 P M Standard Work Rate Maximum Work Rate (102 Liter Minute Vol.) 4 Hoosier Fire Equipment, Inc. 4 Hoosier Fire Equipment, Inc. 0 0 3 4009 Montdale Park Drive 3 4009 Montdale Park Drive to N a a L t U U 2 2 `1 a 7 7 N N N N 1 1 EL a a a U U a a C E O Valparaiso, Indiana 46383 R Valparaiso, Indiana 46383 U_ u. 1 1 0 1000 2000 3000 4000 5C00 0 1000 2000 3000 4000 5000 Supply Pressure PSI) Supply Pressure (PSI) Minimum Maximum Breathing Results Minimum Maximum 0.4 in. H2O 2.4 in. H2O Pass Facepiece Pressure 0.4 in. H20 in. H2O Pass 02/22/2008 1:15:17 PM Randei Herma Replaced diaphragm, EBSS hose, and cylinder retention latch. Tested by Randel Herma Service Center: Hoosier Fire Equipment, Inc. Signature ll1 Page 1 of 1 Version 3.22 SCOTT PosiChek3 02/22/2008 12:01:44 scjrfr PosiChek3 PM Visual Functional Test Results calibration was up Scott CARMEL FD to date when this Air -Pak 4.5 2 CIVIC SQUARE test was L02005 performed. CARMEL 6048 CARMEL, IN 46032 Apparatus Tested Functional Tests Location CFD Facepiece Leak Test Pass 0.1 in. H2O Other ID Exhalatior}:Pressure Pass 1 m H20; Auxiliary IDs Remote Pressure Gauge Pass Facepiece Martin, Dave 1000 PSI 2000 PSI Re tlator N.i0Q13136EZVQ Pass 1076 Pass 2010 Reducer 00110108 Alarms Activation Pass 1101 PSI Low.Pressufe Ala Alr Sauer Switch Pass 3 9 111 H.2 Cylinder y Static Facepiece Pressure Pass 1.1 in. H2O Afrflne Attachment :::.:::a::. Primary Reduder Lockup Pass 95 �S1 Harness Primary Creep Pass -2 PSI Visual Inspection Facepiece /Head Harness Pass ©w Cylinder Transfer Pr Pass 1101 PSI Secondary Reducer Lockup Pass 153 PSI 8ackft amelHarness Pass Secondary Reducer Creep Pass 0 PSI Cylinder N/A Alarms Pass Purge Flow Test Pass 211 L /min HI h Pressure.Leaka e Pass 0 PSI 9 Cy l. Pass 9 Secondary Pr. at High C I. Pass 150 PSI Scott Air -Pak 4.5 -CARMEL 6048 02/2212008 12:01:44 PM Scott Air -Pak 4.5 -CARMEL 6048 02/222008 12:01:44 PM Standard Work Rate Maximum Work Rate (102 Liter Minute Vol.) 4 Hoosier Fire Equipment, Inc. 4 Hoosier Fire Equipment, Inc. 0 0 s 3 4009 Montdale Park Drive 3 4009 Montdale Park Drive N N d d L L U V 2 2 7 N N N N 1 1 o_ o_ v w U V 01 W CL O C 0 d R Valparaiso, Indiana 46383 R V Indiana 46383 LL LL 1 0 1000 2000 3000 4000 5000 1 0 1000 2000 3000 4000 5000 Supply Pressure PSI) Supply Pressure PSI Minimum Maximum Breathing Results Minimum Maximum 0.4 in. H2O 2.4 in. H2O Pass Facepiece Pressure 0.4 in. H2O 2.7 in. H2O Pass 02/22/2008 1:15:17 PM Randel Herma Replaced diaphragm, EBSS hose, and cylinder retention latch. Tested by Randel Herma Service Center Hoosier Fire Equipment, Inc. Signature Page 1 of 1 Version 3.22 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)) 02/29/08 0067055 -IN Repair SCBA $638.00 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 VOUCHER NO. WARR NO. ALLOWED 20 Hoosier Fire Equipment IN SUM OF 4009 Montdale Park Drive Valparaiso, IN 46383 $638.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# 1 Dept, INVOICE NO. ACCT #[TITLE AMOUNT Board Members 1120 0067055 -IN 43- 509.00 $638.00 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 r o Title Cost distribution ledger classification if claim paid motor vehicle highway fund