179658 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 363420 Page 1 of 1
ONE CIVIC SQUARE FIRE ENGINEERING CHECK AMOUNT: $29.95
CARMEL, INDIANA 46032 PO BOX 3498
`o NORTHBROOK IL 60065 CHECK NUMBER: 179658
CHECK DATE: 11124/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4355200 29.95 SUBSCRIPTIONS
Ibb W RENEWAL NOTICE USA Canada 1NT'L
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3 Year Subscription $94.95 ❑$121.95 ❑$170.95
DAVID HABOLISH
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CARMEL FIRE DEPT g g
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CARMEL IN 46032 -7543
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1. Are you a member of a fire department 4. Population Served by Department 6. Do you purchase, recommend, specify or
(municipal, county or state)? 01 Under 2,500 approve purchases for your department?
1 8' s (go to questions 2 -6) 02 2,501- 10,000 1 Yes
0 No (go to question 7) 03 10,001- 25,000 0 ErKo
04 25,001 50,000
2. Rank or Title: 05 Ja10,00 I 100,000 7. Other relationship to the fire service:
01 Chief of Department 06 100,001 500,000 22 Industrial, institutional, military,
02 �iKtaff Chief 07 Over 500,000 airport, high -rise, or other organization
03 Other Officer with special fire prevention or
04 Firefighter 5. Function (check ALL that apply): suppression requirements
05 Training Officer 01 �Vlanagement 23 Fire Prevention and fire protection
06 Other 02 Training engineering firm, fire consultant,
03 Prevention arson investigation organization or
3. Volunteer or Paid: 04 Suppression
01 �V lunteer pp insurance company
02 1 I V lu 05 Investigation 21 Other government dept or agency
03 ❑Combination Paid/Volunteer 06 Maintenance 24 Fire equipment manufacturer
07 Communication 25 Fire equipment distributor
08 Public Education 26 School
09 EMS 27 Public Library
10 Hazmat 28 Fire association, fire museum, TV, radio
11 Rescue 29 Other
12 Other
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fire Engineering
IN SUM OF
P.O. Box 3498
Northbrook, IL 60065
$29.95
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 43- 552.00 $29.95 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
NOV 2 3 2009
7— v
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts I 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))
Haboush $29.95
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