198975 07/06/2011 CITY OF CARMEL, INDIANA VENDOR: 079150 Page 1 of 1
ONE CIVIC SQUARE DONLEY SAFETY
CARMEL, INDIANA 46032 5546 ELMWOOD AVE CHECK AMOUNT: $195.61
INDIANAPOLIS IN 46203 CHECK NUMBER: 198975
CHECK DATE: 7/6/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 W1874 195.61 AUTO REPAIR MAINTEN
DKEY Invoice
SIM Please visit us on the web at www.donleysafety.com
Phone 317. 736 -2266 Date Invoice
5546 Elmwood Ct, Fax 317- 766 -2632
Indianapolis, IN 46203
6/14/2011 W1874
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 1670 75502 1 GDE4V 19781`418435
Item Quantity Description Rate UOM Amount
57202 1 OIL FILTER 7.52 7.52
15W40 OIL 3.5 15W40 OIL 12.94 45.29
LABOR REPAIR REAR FLIP STEP GROMETS, 0.00 LABOR HRS 0.00
"TIGHTENED UP BOLTS WITH NYLOCKS
LABOR 1.5 CHANGED OIL AND FILTER 85.00 LABOR HRS 127.50
SHOP MISC. SHOP SUPPLIES, CLEANING 15.30 15.30
SUPPLIES, ETC.
Sales Tax (7.0 $0.00
PRICE DISCREPANCIES, RETURN REQUESTS OR Total $195.61
SHIPMENT ERRORS MUST BE REPORTED WITHIN
30 DAYS TO RECEIVE CREDIT. Ifyou have questions
about this invoice. Please call Debra O'Dair
317- 786 -2268 or email to dodair @donleysafety.com
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))
W1874 VIN 8435 $195.61
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
Donley Safety
IN SUM OF
5546 Elmwood Court
Indianapolis, IN 46203
$195.61
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. F INVOICE NO. I ACCT #/TITLE AMOUNT Board Members
1120 I W1874 I 43- 510.00 I $195.61 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
JUL 1 7,01J
,ei
4
1
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund