HomeMy WebLinkAbout178351 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 252310 Page 1 of 1
ONE CIVIC SQUARE PRO AIR INC
h �l' CHECK AMOUNT: $1,130.00
CARMEL, INDIANA 46032 1126 AIR DRIVE
o� BLOOMINGTON IN 47404 CHECK NUMBER: 178351
CHECK DATE: 10/14/2009
DEPARTMENT ACCOUNT PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351501 2005001 1,130.00 EQUIPMENT MAINT CONTR
REMIT TO:
P,13 A i INVOICE Koorsen Fire Security, Inc
2719 N. Arlington Ave.
www.koorsen.com Indianapolis,. IN 46218 -3322
Please include invoice
OWE 5 Number on check.
INC.
INVOICE 2005001 SERVICE CUST.
A DIVISION OF KOORSEN NUMBER DATE P.O. NO.
Phone 812 336 -4022 INVOICE 09/10/2009 RV 10/0.5/2009 DATE DUE 10/0.5/2009
Toll Free 800 245 -0269 DATE ORD.#
Cust ID 21CAR0002 SERVICE21 /0
Invoice to: TERMS: Net 25 Days Job
Service Location:
CARMEL FIRE DEPT CARMEL FIRE DEPT
2 CIVIC SQ 2 CIVIC SID
CARMEL, IN 46032 CARMEL, IN 46032
21 —HOUSE
QUANTITY ITEM DESCRIPTION UNIT PRICE TOTAL
ANNUAL BILLING AIR SAMPLE SERVICE 450.00
OCTOBER 01, 2009 THRU SEPTEMBER 30, 2010
ANNUAL BILLING AIR COMPRESSOR MAINT 680.00
OCTOBER 01, 2009 THRU SEPTEMBER 30, 2010
Total 1,130.00
To pay by credit card, please phone or return to us:
Card number----
Visa MasterCard American Express
Name on card Expiration date
Signature X
TOTAL SALES TAXABLE SALES TAX AMOUNT SHIPPING CHARGE PLEASE PAY
1,130.00 1 1 30 .00 0.00 THIS AMOUNT 1 1 30.00
Federal ID 35- 1153549 A service charge of 1 1 2% per month (18% annual) will be charged on past due accounts.
KFPA 001 (8108) CUSTOMER COPY
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VOUCHER NO. r WARRANT NO.
ALLOWED 20
Pro'-Air
IN SUM OF
1126 Air Drive
Bloomington, IN 47404
$1,130.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 2005001 43- 515.01 $1,130.00 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
OCT 12 2009
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))
2005001 $1,130.00
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