180236 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 355226 Page 1 of 1
ONE CIVIC SQUARE PUBLIC SAFETY CENTER, INC CHECK AMOUNT: $276.81
o CARMEL, INDIANA 46032 PO BOX 2370
;t'oN Lo+ EUGENE OR 97402 CHECK NUMBER: 180236
CHECK DATE: 12/812009
DEPARTMENT ACCOUNT PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 1878891IN 198.00 SPECIAL DEPT SUPPLIES
102 4239011 187889IN 78.81 SPECIAL DEPT SUPPLIES
P>l bfic Safety Center, Inc. "Electronic Transfer"
ACH only (no wire transfers!)
F.O. Box 2370 pay directly horn your ban's to ours!
Eugene, OR 97402 Use our routing 123 Order Date invoice
and our account 20025714
11/17/2009 187889IN
5411-344 -44345 Fax 541. 666.1373
Bill To Ship To
Carmel Dire Dept Carmel Fire Dept
Attn: Accounts payable Attn: Mark Hulett
2 Civic Sq 2 Civic Sq
Carmel IN 46032 Carmel IN 46032
P.O. Number Terms Rep Name invoice /Ship Date Ship Via Customer Phone
Net 30 Scots 11/17/2009 Ground 317/571 2600
Quantity Item Code Description Price Each Amount
12 A4502(30 -10... Shears, 7.25" RED 2.09 25.08
15 Shipping Processing (NOTE: Includes
shipping processing for any items to
follow, Remainder of items to follow)
1 Shipping Processing 53.73 53.73
1 1 FeclEx Ground Tracking Number(s):
073671580163216
o W $78.81
W -9 INTORIl4ATION: PUBLIC SAFETY C.FNTER IS AN OREGON CORP FIN #93- 1319770
ANY ITEMS RETURNED 60 DAYS OR NIORF AFTER RECEIPT ARE SUBJECT TO A 10% RESTOCK FEE.
-PuUfic Sa eh, C enter, Inc. "Electronic Transfer" Invoice
P.O. Box 2370 ACH only (no wire transfers!)
Pay directly fronn your bank to ours!
Eugene, OR 97402 pticm Use our routing;? 123205135 Order Date Invoice
and our account 20025714
11/17/2009 1878891IN
541-3" -4434 Fox 549 586 -1373
Bill To Ship To
Carmel Fire Dept Carmel Fire Dept
Attn Accounts payable Attn: Park Hulett
2 Civic Sq 540 W 136 St
Carmel IN 46032 Carmel IN 46032
P.O. Number Terms Rep Name Invoice /Ship Date Ship Via Customer Phone
Net 30 Scots 11/17/2009 Ground 3171571 -2600
Quantity Item Code Description Price Each Amount
2 1059 Hudson Adult Non- Rebreat:Nng Mask (With 99.00 x °R.Ov
Safety 'Dent) 50 /case
5 NOTE: All Freight for this Invoice previously
billed.
1 Shipping Processing 0.00 0.00
1 1 FedEx Ground Tracking Numbers):
073671580163223,073671580163230
ToW $198.00
W -9 INFORMATION: PUBLIC SAFETY CENTER IS AN OREGON CORP FIN 493-13191
ANY" ITEMS RETURNED 60 DAYS OR MORE ASTER TER RECEIPT ARE SUBJECT TO A 10% RESTOCK FEE.
VOUCHER NO, WARRANT NO.
ALLOWED 20
Public Safety Center
IN SUM OF
P.O. Box 2370
Eugene, OR 974
x
$276.81
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO, ACCT #/TITLE AMOUNT Board Members
1120 1878891 IN 102 390.11 $198.00 1 hereby certify that the attached invoice(s), or
1120 187889IN 102 390.11 $78.81 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
DEC m �nng
u
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
P.n invoice or bitl 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))
1878891 IN $198.00
187889IN $78.81
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