159848 05/28/2008 a CITY OF CARMEL, INDIANA VENDOR: 361344 Page 1 of 1
ONE CIVIC SQUARE CURTIS DYNA -FOG CHECK AMOUNT: $205.00
CARMEL, INDIANA 46032 PO BOX 297
WESTFIELD IN 46074 CHECK NUMBER: 159848
CHECK DATE: 5/2812008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 34091 205.00 OTHER CONT SERVICES
Invoice 34091
CURTIS DYNA 10,
Invoice Date 05/05/08
CURTIS DYNA -FOG, LTD.
17335 US 31 North
PO Box 297
Westfield, IN 46074 USA
Telephone: 3171896 -2561
Bill To: Ship To:
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE CALL FOR PICK UP 664 -0958
CARMEL, IN 46032 CARMEL, IN 46032
Customer -,Ship �/la i''M..,�:,, r der ',Terms r.."
F.OB
21246 CUST PICK UP Westfield Net 30 Days
a urchase Ord er�;Number,,�:,'.'�5alesperson .,order Date;.�i n� Our Order Number
REPAIR 1 04/07/08 31859
Quantity Shipped ltem,Number Unit of Measure 'Unit Price
Quantity rdered Extended Price
Y Back Ordered Item .Description Discount Tax
2 2 43016 EA. 0.8000 1.28
0 BOTTOM CARBUR.GASKET 20.000 N
1 1 58212 -8 EA, 0.7500 0.60
0 TUBE,114 NYL -6.0 IN 20.000 N
1 1 58683 -1 EA 22.0000 17.60
0 VALVE AY,PRESS, AFLAS 20.000 N
1 1 85916 EA. 2.9500 2.36
0 ELBOW,BRASS,1 18 MP -3/16 BARB 20.000 N
1 1 80408 EA. 1.6000 1.28
0 FILTER, POROUS BRONZE 20.000 N
1 1 10100 -14 EA. 0.5500 0.44
0 O -RING 20.000 N
1 1 10100 -7 EA. 0.3500 0.28
0 O -RING 20.000 N
1 1 10100 -8 EA. 0.3500 0.28
0 O -RING 20.000 N
Net due on 06/04/08
(Continued)
Duplicate
Page 2
Invoice 34091
CURTIS DYNA,,, Invoice Date 05/05/08
CURTIS DYNA -FOG, LTD.
17335 US 31 North
PO Box 297
Westfield, IN 46074 USA
Telephone: 3171896 -2561
Bill To: Ship To:
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE CALL FOR PICK UP 664 -0958
CARMEL, IN 46032 CARMEL, IN 46032
Customer t Ship.Via E:O.B•.. Terms
21246 CUST PICKUP Westfield Net 30 Days
Salespers
Purchase Order Number on O,rder;;Date ::Our OrderNumber
REPAIR 1 04/07/08 31859
Quantity Ordered Ordered: Item Number Unit of Measure Discou price Tax ed Price
Quantit Shipped:
y rdered Extend
Ordered Item Description
1 1 LABOR 85.0000 85.00
0 REPAIR LABOR GH -6 SN #1125 N
1 1 43137 EA. 102.1500 81.72
0 IGNITION COIL AY 20.000 N
1 1 20466 -4 EA. 1.7500 1.40
0 TUBE, NYL,NF44 -.125 (7.375 20.000 N
2 2 58636 -1 EA 3.0000 4.80
0 TUBING, REIN PVC.1251D 20.000 N
1 1 80447 -18 EA, 1.6000 1.28
0 TUBE,VINYL,.312 GRES 20.000 N
1 1 80447 -21 EA 1.3500 1.08
0 Tubing 20.000 N
1 1 80447 -22 EA. 3.8000 3.04
0 TUBE,VINYL,.312 GRES 20.000 N
2 2 32109 EA. 0.9000 1.44
0 VENTURI,GASKET 20.000 N
Net due on 06/04/08
(Continued)
Duplicate
Page 1
p
Invoice 34091
CUR ISYN n k Invoice Date 05/05/08
t h
k�
ii. t IiMir.
CURTIS DYNA -FOG, LTD.
17335 US 31 North
PO Box 297
Westfield, IN 46074 USA
Telephone: 317/896 -2561
Bill To: Ship To:
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE CALL FOR PICK UP 664 -0958
CARMEL, IN 46032 CARMEL, IN 46032
Customer Ship Via F.O B. Icy_ Terms
21246 GUST PICK UP Westfield Net 30 Days
Purchase Order'Niimber .s Salespers'on, brder Date Our Qrder Number
REPAIR 1 04/07/08 31859
Quantity Shipped Item Numl er !I "�I` Unit,of Measure I� Unit Price
Quantity Ordered Extended Price
Back Ordered Item Description Discount, %o Taxi;,
1 1 10247 -60 EA. 1.4000 1.12
0 ORIFICE 20.000 N
Net due on 06/04/08
Nontaxable Subtotal 205.00
Taxable Subtotal 0.00
Tax (7.000 0.00
Total Invoice 205.00
Duplicate
Page 3
VOUCHER NO. WARRANT NO.
ALLOWED 20
Curtis Dyna -Fog
IN SUM OF
P.O. Box 297
Westfield, IN 46074
$205.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT# /TITLE AMOUNT Board Members
1 120 34091 43- 509.00 $205.00 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
6
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
05/05/08 34091 Repair Fog Machine $205.00
1 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