204046 11/21/2011 CITY OF CARMEL, INDIANA VENDOR: 318000 Page 1 of 1
ONE CIVIC SQUARE VAN'S ELECTRICAL SYSTEMS INC CHECK AMOUNT: $20.62
CARMEL, INDIANA 46032 PO BOX 51797
INDIANAPOLIS IN 46251 CHECK NUMBER: 204046
CHECK DATE: 11121/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 419285 20.62 REPAIR PARTS
REMIT TO: I N V O I C E pa 1
P.O. Box 51797
1 f
Indianapolis, IN 46251 Itiv 419285 C)rd#
F P.O. NO.
317 -240 -5900 ACCOUNT NO.
ELECTRICAL SYSTEMS vanselec.com VANS t_1i_I_IVtI�Y 0 10171
Inds Kentucky Avenue �F C; H H R G E:: CUST. SVC. REP.
Indianapolis, IN 46221
310 1 5 0 A''r'3 1:E: f q '.3E k1;= 1..t.)4J.. ':)V 90
DATE
s C f R H E 1 F I R E S C_:fal=?H 1_ 1= IRE DEPT f 1 1 1 2() 1 1
o C I V I i; :�C. H c C IVIC Eat TIME OF ORDER
D t:F+khtc:l_ I tl 'Si7:a;� P +:::AR I'lF.l._ It'd =I t)t)
T T
0 O 14 t{ t1 iC I d1 .t
Part Number Order Ship B/O Description List Net Value
C�H '3 -13X 4 2 2 i' N(j ;•fh1{= T 21 .07 10.31N 20 .6 2'
AX RATE NO DISCOUNT ON CORES TAX FREIGHT
TOTAL UNITS PART TOTAL CORE TOTAL FREIGHT HANDLING OTHER TAX
c 2 .S'i
PAST DUE ACCOUNTS WILL BE CHARGED 1'h% INTEREST PER MONTH
(18% PER ANNUM) RETURNED GOODS MUST BE ACCOMPANIED BY INVOICE. RE- RCVD.
TURNED GOODS SUBJECT TO RESTOCKING CHARGE. NO CREDIT ON PART BY. X 20.62
IF IT HAS BEEN INSTALLED. DISCREPANCIES TO BE REPORTED WITHIN 7 DAYS.
VOUCHER NO. WARRAN NO.
ALLOWED 20
Van's Electrical Systems
IN SUM OF
P.O. Box 51797
Indianapolis, IN 46251
$20.62
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #!TITLE I AMOUNT Board Members
1120 I 419285 I 42- 370.00 I $20.62 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 1 2011
l n
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))
419285 E43 $20.62
I 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