156730 02/21/2008 CITY OF CARMEL, INDIANA VENDOR: 00350730 Page 1 of 1
ONE CIVIC SQUARE NASCO CHECK AMOUNT: $4.59
CARMEL, INDIANA 46032 901 JANESVILLE AVE
FORT ATKINSON WI 53538 -0901 CHECK NUMBER: 156730
on co
CHECK DATE: 2/21/2008
DEPARTMENT ACCOU PO NUM INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 187042 4.59 REPAIR PARTS
IT
r ry
GI,U`iO fort Atkinson
901 JANESVILLE AVENUE Date Amount Due Page
FORTATKINSON, WI 5353"901
(920) 563 -2446 FAX (920) 563 -8296 1/21/08 $4.59 1 of 1
TOLL FREE (600) 558 -9595 Order No. Contract P.O. Number
87- 2015 -S
Account Invoice No. Sis Code WS Id
127 355 -00 187042 1 AUTO
Special Information Cash with Order
1270 Shipping Instructions Requested Date
CARMEL FIRE STATION 44
5032 EAST 131 ST ST
CARMEL IN 46033 -8392
Itlttltllttlltttttlltttlltltlltttlltltlttttltlttlltttltllttlll Remit to:
Nasco
P.O. Box 901
III IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII�III�� III I
Fort Atkinson WI 53538 -0901
Itltltttllttltltttlltlttltlltttltlttllttttt 'tllllttltttlltltltl
For proper credit to your account, please return this portion with your remittance and write your customer numberfinvoiceM_on your check.
Account: 127 355 -00 P.O. Number: Order No.: 87. 2015 -S Invoice No.: 187042 Date: 1/21/08
Ordered Shipped Backorder U/M Catalog bescriptiori Price Extended
1 AUTO
"REPAIR ORDER"
1 1 S07201501 U SHOULDER DISK F /CRISIS MNK .00
*YOUR ORDER IS COMPLETE*
*WITH THIS INVOICE
Sold To: CARMEL FIRE STATION 44 Ship To: CALLAHAN. CAPTAIN MARK NET TOTAL 0.00
5032 EAST 131ST ST CARMEL FIRE STATION 44 SHIPPING /INSURANCE /HANDLING 4.59
CARMEL IN 46033 -8392 5032 EAST 131ST ST
ORIGINAL INVOICE CARMEL IN 46033 SUB TOTAL: 4.59
TERMS: NET 30 DAYS
mss,[ TOTAL DUE: 4.59
adCQ fort Atkinson
901 JANESVILLE AVENUE
9 0) 563 -2446 N FAX (920) 563 8296 THANK YOU
TOLL FREE 4800) 558 -9595 FED.I.D.NO. 06-1165854
For Your Order
For proper credit to your account, please return top portion of this document with your remittance and write your account number /invoice# on your check. All claims for damages and/or shortages MUST be reported
WITHIN 10 DAYS after receipt of merchandise MERCHANDISE MAY NOT BE RETURNED WITHOUT AUTHORIZATION
PrescribedTiy State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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 y .S
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
f
VOUCHER NO. WAR.RkNT 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
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
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund