178124 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 079150 Page 1 of 1
o_ ONE CIVIC SQUARE DONLEY SAFETY CHECK AMOUNT: $559.40
P O BOX 33396
CARMEL, INDIANA 46032
2u INDIANAPOLIS IN 46203
CHECK NUMBER: 178124
CHECK DATE: 10/14/2009
DEPARTMENT ACCO PO NU MBER INVOICE NUMBER A MOUNT DESCRIPTION
1120 4351000 9 -1208 559.40 AUTO REPAIR MAINTEN
JJONLEY Please visit us on the web at www.donleysafety.com
Mw
Invoice
1718 VILLA AVE. Phone 317 786 -2268 Date Invoice
P.O. BOX 33396 Fax 317 786 -2532
INDIANAPOLIS, IN. 46203 9/1/2009 9 -1208
Bill To Service Info
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL- IN. 46032 CARMEL, IN. 46032
S.O. No. Terms Rep Vehicle Mileage VIN
108975 Due on receipt FS eng 42 40842 4Z3AAA843RK92637
Item Quantity Description Rate UOM Amount
LABOR 2.2 OUTRIGGERS WILL NOT WORK: PTO KICKS OUT, BAD 80.00 HR 176.00
LADDER CRADLE SWITCH. SERVICE CALL TO
CUSTOMER TO TROUBLESHOOT THE PROBLEM.
ORDERED PARTS. WHEN PARTS CAME IN,
CUSTOMER PICKED THEM UP AND INSTALLED
THEMSELVES.
SHOP I MISC. SHOP SUPPLIES, CLEANING SUPPLIES. ETC. 21.12 21.12
REPAIR PARTS I 7872000170 LIMIT SWITCH 272.88 272.88
REPAIR PARTS 1 7872000185 LEVER ARM 74.40 74.40
S- INBOUND I INBOUND FREIGHT FOR SPECIAL ORDER ITEM(S) 15.00 15.00
Sales Tax (7.0 $0.00
PRICE DISCREPANCIES, RETURN REQUESTS OR Total $559.40
SHIPMENT ERRORS MUST BE REPORTED
30 DAYS TO RECEIVE CREDIT. If you have questions
about this invoice, Please call Debra O'Dair
317 786 -2268 or email to dodair @donleysafety.com
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))
9 -1208 $559.40
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
VOUCHER NO. WARRANT N
ALLOWED 20
Donley Safety
IN SUM OF
P.O. Box 33396
Indianapolis, IN 46203
$559.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 9 -1208 43- 510.00 $559.40 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
O CT 12 2009
1 n
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund