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200932 08/30/2011 CITY OF CARMEL, INDIANA VENDOR: 178450 Page 1 of 1 ONE CIVIC SQUARE KUSSMAUL ELECTRONICS CO IN ti•.�� CARMEL, INDIANA 46032 170 CHERRY AVE CHECK AMOUNT: $79.11 v L WEST SAYVILLE NY 11796 -1221 CHECK NUMBER: 200932 CHECK DATE: 8/30/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUM AMOUNT DESCRIPTION 1120 4350900 43180 79.11 OTHER CONT SERVICES Q AU INVOICE 43180 ELECTRONICS CO., INC. 170 CHERRY AVENUE WEST SAYVILLE, DIY 11796 -1221 USA, Page Date?. TEL: 631 567 -0314, FAX: 631 567 -5826, www.kussmaul.c ©m, sales@kussmaul.cam 1 8/12/11 Sold to: Ship to: CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL IN 46032 CARMEL IN 46032 ACCQ.UIT N� CUST(7it4t R ORi7E>i NO S'kL$SPERSON TERMS SALES QRDER CAR033 JASON CHRIS TAMARGO NET 30 DAYS 288978 ORDER',DATE F.C!i6 POINT SHIPPEDVYA;;: H DATE;SHiPPED JV�.PACKAGES 8/12/11 W.SAYVILLE FEDEX GROUND RESID. 8/12/11 1 Tl ORD1 IZED PART IVUM. BER 17E5CRIPl ION SERIALNO ltPdETFRhCE NET PRICE 1 REPAIR OF 091 -IBWP -120 .00 65.00 65.00 S/N W23001992. REPAIR WPO98 SHIPPING TRACKING 023887510204095 PLEASE WRITE INVOICE NUMBER ON ALL PAYMENTS SUBTOTAL 65.00 NO RETURNS ON C.O.D. SHIPMENTS OR ANY SHIPMENTS UNDER $50.00 SHIPPING HANDLING 14.11 ALL RETURNS SUBJECT TO 10% RESTOCKING CHARGE TAX 00 ABSOLUTELY NO RETURNS AFTER 30 DAYS ALL PAYMENTS IN U.S. DOLLARS ORIGINAL:'INVOI' TOTA $79.11 PLEASE PAY THIS AMOUNT----- HOME OF THE A UTO CHARGE A UTO EJECT AIR EJECT A UTO PUMP REPAIR ODDER WP AUTO EJECTS KUSSMAUL ELE&RONICS CO., INC REPAIR ORDER r 170 CHERRY AVENUE, WEST SAYVILLE, NEW YORK 11796 R.G.A. TEL IN NY: 631 -567 -0314 TOLL FREE: 800- 346-0857 DATE: CUSTOMER: �r(�y�� f. re DPf e EQUIPMENT: WP AUTO EJECT SERIAL 9: w a2sm Iq a ADDRESS: PROJECT M 091 -I6 WP- ;>o SALES ORDER C 2 CUST. ACCT. C A (CJ PHONE: P.O. C d REPAIR AUTHORIZED BY: MFG. DATE: CUSTOMER COMPLAINT: PHYSICAL INSPECTION: UNIT RETURNED FOR CREDIT UNIT LOOKS NEW Q UNIT DOES NOT EJECT UNIT LOOKS USED INSTALLED UNIT WORKS INTERMITTENTLY NIT HAS DAMAGED PARTS PROBLEM WITH UNIT: REPAIR ACTION: NO PROBLEM FOUND REPLACED PINS RECEPTACLE EJECT PIN ARCED DAMAGED PINS RECEPTACLE REPLACED SOLENOID DAMAGED INOPERATIVE SOLENOID REPLACED MOUNTING FLANGE HOUSING DAMAGED MOUNTING FLANGE HOUSING REPLACED TERMINAL SCREWS MISSING DAMAGED TERMINAL SCREWS REPLACED TRIGGER PLATE/ SPRINGS WORN TRIGGER PLATE SPRING EJECT PIN REPLACED POP RIVETS WATER DAMAGE (NOTE WATER DAMAGE UPDATED OLD STYLE HOUSING IS NOT COVERED UNDER WARRANTY) CLEANED AND TESTED UNIT Q COMMENTS: r QTY. PART f UNIT EXT. TECHNICIAN: Justine B. 091 -18-053 MOUNTING FLANGE HOUSING ST REPAIR 091 -18-057 EJECTION PIN 091 -18-091 LINE PIN 091 -18-093 NEUTRAL PIN MATERIAL COST 091 -18-102 15 AMP RECEPTACLE 091 -18 -105 20 AMP RECEPTACLE SUB TOTAL 09118 -116 GROUND PIN 373 -8712 VOLT SOLENOID SHIPPING [:3.53732-88 24 VOLT SOLENOID ADS42 POP RIVETS TOTAL COST SEE INVOICE WARRANTY All MATERLALS AND LABOR ON THIS REPAIR ORDER ARE GUARANTEED FOR A PERIOD OF 30 DAYS AFTER RETURN OF EMXPMEI+TT TO CUSTOMER- THE EQUIPMENT IS TESTED UPON THE OOMPLETiON OF ALL REPAIRS. KUSSMAUL ELECTRONICS 00.. INC. IS NOT LIABLE FOR THE SUBSEQUENT FAILIURE OF ANY PARTS NOT LISTED ON THIS ORDER, OR FOR DAMAGE THAT MAY RESULT WHEN THE EQUIPMENT IS INSTALLED. VOUCHER N.O. WARR NO. Kussmaul Electronics ALLOWED 20 IN SUM OF 170 Cherry Avenue West Sayville, NY 11796 $79.11 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# I Dept. INVOICE NO. ACCT #FrfTLE AMOUNT Board Members 1120 I 43180 43-509.00 $79.11 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 AUG se n 2011 Fire Chief 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)) 43180 $79.11 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