175675 08/06/2009 CITY OF CARMEL, INDIANA VENDOR: 079150 Page 1 of 1
ONE CIVIC SQUARE DONLEY SAFETY
a CARMEL, INDIANA 46032 P 0 BOX 33396 CHECK AMOUNT: $18.69
INDIANAPOLIS IN 46203 CHECK NUMBER: 175675
CHECK DATE: 8/6/2009
DEPARTMENT ACCOUN PO NUMBER INVOICE NUMBER AMOUN DESCRIPTION
1120 4237000 22569 61.70 REPAIR PARTS
1120 4237000 22662 86.06 REPAIR PARTS
1120 4237000 CR22141 129.07 REPAIR PARTS
ONLEY YOU CAN SHOP ON LINE AT INVOICE
WWW, DONLEYSAFETY. COM
1718 VILLA AVE. rnone si i- ron t�nu Date Invoice
P.O. BOX 33396 Fax 317.786 -2532
7/13/2009 22662
INDIANAPOLIS, IN. 46203
Bill To Ship To
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL, IN. 46032 CARMEL, IN. 46032
P.O. Number Terms Salesperson Ship Via F.O.B. Order Date
VERBAL NET30 DG WILL CALL
Ordered Shipped B/O Item Number Description Unit Price UOM Ext. Price
1 0 02840863 HANDLE ASSEMBLY RH 2PT 86.06 EACH 86.06
Sales Tax (7.0 $0.00
PRICE DISCREPANCIES, RETURN REQUESTS OR Total
SHIPMENT ERRORS MUST BE REPORTED WITHIN 30 $86.06
DAYS TO RECEIVE CREDIT.
Questions about this invoice? Please call 317- 786 -2268.
ONLEY NOW YOU CAN SHOP ON LINE AT INVOICE
SUEff WWW. DONLEYSAFETY. COM
1718 VILLA AVE. rnone ri f- roo -ccoo Date Invoice
P.O. BOX 33396 Fax 317 786 -2532
7/3/2009 22569
INDIANAPOLIS, IN. 46203
Bill To Ship To
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL, IN. 46032 CARMEL. IN. 46032
P.O. Number Terms Salesperson Ship Via F.O.B. Order Date
VERBAL NET30 DG WILL CALL
Ordered Shipped Bio Item Number Description Unit Price UOM Ext. Price
1 1 0 REPAIR PARTS 555 -SHOW DOOR CLOSER 29.85 29.85
1 1 0 018290V001 WINDOW CRANK 21.09 21.09
1 1 0 SFREIGHT SHIPPING HANDLING 10.76 10.76
Sales Tax (7.0 $0.00
PRICE DISCREPANCIES, RETURN REQUESTS OR Total
SHIPMENT ERRORS MUST BE REPORTED WITHIN 30 $61.70
DAYS TO RECEIVE CREDIT.
Questions about this invoice? Please call 317- 786 -2268.
NOW YOU CAN SHOP ON LINE AT Credit Illamo
r W WWDONLEYSAFETY.COM
Date Credit No.
1718 VILLA AVE. rnone sir- IM -ccoo
P.O. BOX 33386 Fax 317- 786 -2532 5/31/2009 CR22141
INDIANAPOLIS, IN. 46203
Customer Ship To
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL, IN. 46032 CARMEL, IN. 46032
P.O. No. Rep Project
DG
Item Description Qty Rate UOM Amount
CREDIT FOR ITEM(S) RETURNED:
915239 -33 GUAGE, LIQUID FILLED, 30 TO 600 PSI -1 50.18 EACH -50.18
WHITE FACED
91553940 3.5 GAUGE -1 78.89 78.89_
Subtotal 129.07
Sales Tax (7.0 $0.00
Total 129.07
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))
CR22141 Credit ($129.07)
22569 E43 $61.70
22662 A45 $86.06
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Donley Safety
IN SUM OF$
P.O. Box 33396
Indianapolis, IN 46203
$18.69
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 CR22141 42- 370.00 ($129.07) 1 hereby certify that the attached invoice(s), or
1120 22569 42- 370.00 $61.70 bill(s) is (are) true and correct and that the
1120 22662 42- 370.00 $86.06
materials or services itemized thereon for
which charge is made were ordered and
received except
AUG 3 2009
c
e
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund