158318 04/15/2008 CITY OF CARMEL, INDIANA VENDOR: 361137 Page 1 of 1
1 ONE CIVIC SQUARE CARMEL FIRE DEPT CHECK AMOUNT: $500.00
CARMEL, INDIANA 46032 STATION 41 FUND
CHECK NUMBER: 158318
CHECK DATE: 4115/2008
DEPARTMENT ACCOUNT PO NUMB INVOICE NUMBE AM DESCR
102 4463300 500.00 APPLIANCES
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MARKETING
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5830 Industrial Road Bus: 219 -484 -2556
1 -500- 675 "9304 O P0. Box 5122 Orders: 1- 800 -777 -4856
Fort Wayne. IN 46895 Service: 219 -484 -2095
ORDER, FORD
Sold To: t 16V,04- Ship To:
Order Date Pur. Order No. Date Shipped How Shipped Terms Salesman
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Quantity Ordered Quantity Shipped Stock Number Description Unit Price Extension
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Return FAX Requested MYES M NO Return Call Requested ,/YES M NO
Confirm Order Confirm Order
Item Availability Item Availabili
COD Total COD Total
FAX Phone
Attn: Contact:
X
Dealer Signature Approval
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VOUGHER N'O. WARRANT NO.
ALLOWED 20
Station 41 Station Fund
IN SUM OF
$500.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
102- 633.00 $500.00 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
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))
N Sta. 41 $500.00
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk Treasurer