156623 02/21/2008 CITY OF CARMEL, INDIANA VENDOR: 131135 Page 1 of 1
ONE CIVIC SQUARE HOOSIER FIRE EQUIPMENT INC
CARMEL, INDIANA 46032 4009 MONTDALE PARK DRIVE CHECK AMOUNT: $76.50
VALPARAISO IN 46383
CHECK NUMBER: 156623
CHECK DATE: 212112008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
1120 4237000 66700 76.50 REPAIR PARTS
INVOICE PAGE: 1
Hoosier Fire Equipment, Inc. INVOICE NUMBER: 0066700 -IN
4009 Montdale Park Drive INVOICE DATE: 01/30/08
Valparaiso, Indiana 46383
ORDER NUMBER: 0100516
ORDER DATE: 01/02/08
(219) 462 -1707 SALESPERSON R. W. Pressel
CUSTOMER NO: CARMOI
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. I UNIT ORDERED SHIPPED BACK ORD PRICE AMOUNT
805622-01 EACH 1.00 1.00 0.00 34.50 34.50
SCOTT TWIN, QUARTER TURN ADAPTER ASSEMBLY
/SORDER EACH 1.00 1.00 0.00 35.50 35.50
#7422 -FT1, SCOTT PROBE FOR 742 SERIES
7422 -FP1 EACH 1.00 1.00 0.00 6.50 6.50
SCOTT 742 -P100 MINI FILTER FOR XCEL FACEPIECE
TAXABLE .00
NON- TAXABLE 76.50
NET INVOICE: 76.50
SALES TAX: .00
FREIGHT: .00
INVOICE TOTAL: 76.50
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))
Total 5 0
r
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
IN SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
a a a 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
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund