166770 12/10/2008 CITY OF CARMEL, INDIANA VENDOR: 176650 Page 1 of 1
ONE CIVIC SQUARE KOORSEN PROTECTION SERVICE, INC CHECK AMOUNT: $284.20
CARMEL, INDIANA 46032 2719 N ARLINGTON AVE
ti <ron INDIANAPOLIS IN 46218 -3300 CHECK NUMBER: 166770
CHECK DATE: 12/10/2008
D EPARTMENT ACCOUNT PO NUMBER INVOICE N UMBER AMOUNT DESCRIPTION
1115 4350100 1821873 284.20 BUILDING REPAIRS MA
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REMIT TO:
Koorsen Fire Security, Inc.
Koo INVOICE 2719 N. Arlington Ave.
cm.n www.koorsen.com Indianapolis, IN 46218 -3322
FIRE SECURITY Please include invoice
Number on check.
SERVICE BRANCH INVOICE 1. 82 1. 873 SERVICE 1..1. FCUST.
INDIANAPOLIS NUMBER DATE P.O. NO.
(317) 542 -1800 INVOICE 1.1. /2,S 2008 sERV. 1.641.01.5 1.2/20/2008
800- 745 -2719 DATE DATE DUE
Ct_I.st. In OICAR3111. 3ERVICF01
Invoice to: TERMS: Net 25 Days Job
CARMEL_ Cl AY COMM(_ Service Locatipn
JNTCATION CENT C:ARMEI... CI....AY COMW)NICATION CENT
31. IST AVE NISI 31. IST AVE NW
CARMEI.... IN 46032 CARMEi.... IN 46032
01.- H0I,13F 01 371.450 TK01
QUANTITY I ITEM DESCRIPTION UNIT PRICE TOTAL
NOVEMBER FIRE EXTINGUISHER SERt1 Annl_ta 1..
9.00 TNSP --FE -A INSPECTION OF FIRE EXTINGUISHER ANNI_JAI._
1,:00 SIX- DC1..0 SIX YEAR MAINTENANCE DRY CHEM .1.0# STORED PRESSURE 35 „0. 1 55
1.::(50 RE--PKIO RECHARGE PORPI...E K 1.04 STORED PRSSR EXTNG 58 „35 58::3.5
1.::00 HT -OCIO HYDRO TEST DRY CHEM 1.0# 1.6::.50 _1.6::50
1.,:00 RE- -0O2 -1.0 RECHARGE CO2 1.0# STORED PRESSURE FXTNG 76::1.0 76::10
1,,00 HT -0O2 HYDRO TEST CO2 EXTINGUISH ER 2::5# TO 26# 17::75
2::00: BR6092A VAI._VE STEM RPI...C..MNT- AMEREX DC /HAI..ON AI._UM P5 1.0 „45 20::90
2::00 BROR27 O -RING REPI...ACEMENT AM5241 PIO 3::9 1 7,:90
3:.00 CIK1...01.1. I...AREI... INSPECTION HYDR.OTST 6YR 5I..VR P.50
9:,(.50 CIKT001. TAG KOORSFN *F /E --PAPER-- YEI... P50
9,:00; CTKT003 TAG,OSHA--KOORSEN PAPER MONTHI...Y INSPECT -BOFF P.50 1::0.. 9 „00
3:,00 CIKTO23 COI ..I...AR,SERVIC..E VFRIFICATN SM P1.00 7. 2::25
9 „00 BRKSIAI SFAI... KOORSEN I...OGO YEAR 2008 WHITE P1000
1 .,00 99 SERVICE CAI FIRE EXTTNG LUSHER I 45,:00 45:.00
TOTAI... SAI...ES /SERVICES XMP# 0031.201.550020 284::
TOTAL.. 284::20
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To pay by credit card, please phone or return to us:
Card number____-
Visa El Mastercard American Express
Name on card Expiration date l
Signature X
TOTAL SALES TAXABLE SALES TAX AMOUNT SHIPPING CHARGE PLEASE PAY
284 „20 0::00 0::00 THIS AMOUNT 284::20
Federal ID 35- 1153549 A service charge of 1 per month (18% annual) will be charged on past due accounts.
KF -001 (12/05) CUSTOMER COPY
VOUCHER NO. WARRANT NO.
ALLOWED 20
K Fire Security, Inc.
IN SUM OF
2719 N. Arlington Avenue
Indianapolis, Indiana 46218
$284.20
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1115 1821873 43- 501.00 $284.20 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
Friday, December 05, 2008
Director
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))
11/25/08 I 1821873 I I $284.20
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