173302 06/10/2009 CITY OF CARMEL, INDIANA VENDOR: 079150 Page 1 of 1
ONE CIVIC SQUARE DONLEY SAFETY CHECK AMOUNT: $1,318.10
zo CARMEL, INDIANA 46032 P o BOX 33396
INDIANAPOLIS IN 46203 CHECK NUMBER: 173302
CHECK DATE: 6/10/2009
DEPARTM A PO NUMBER INVOICE NUMBER A MOUN T DESCRIPTION
1120 .4237000 22141 456.42 REPAIR PARTS
!1120 4237000 22142 142.84 REPAIR PARTS
1120 4237000 22247 718.84 REPAIR PARTS
ONLEY NOW YOU CAN SHOP ON LINE AT INVOICE
WWW. DONLEYSAFETY. COM
1718 VILLA AVE. rnone sir -r so -ttoo Date Invoice
P.O. BOX 33396 Fax 317 786 -2632
5/29/2009 22247
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
NET30 DG WILL CALL
Ordered Shipped Bio Item Number Description Unit Price UOM Ext. Price
2 2 0 104202 ALUMINUM HANDLE FOR STYLE 11.63 23.26
2581 GATED WYE
2 2 0 744086 PINROL ESNASSTL 302/304 0.96 1.92
I 1 0 91523971 2.5" GAUGE 50.18 50.18
1 I 0 102652 ENFO III DISPLAY 551.45 551.45
0= 400 PS, GAL'IGE 78:89 78 89
1 1 0 S- INBOUND INBOUND FREIGHT FOR SPECIAL 13.14 13.14
ORDER ITEM
Sales Tax (7.0 $0.00
PRICE DISCREPANCIES, RETURN REQUESTS OR Total
SHIPMENT ERRORS MUST BE REPORTED WITHIN 30 71 &.84°
DAYS TO RECEIVE CREDIT.
Questions about this invoice? Please call 317 -786 -2268.
ONLEY YOU CAN SHOP ON LINE AT INVOICE
WWW. DONLEYSAFETY. COM
1718 VILLA AVE, rnvne i gun -ccoo Date Invoice
P.O. BOX 33396 Fax 317- 786 -2532
5/22/2009 22141
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
NET30 DG WILL CALL
Ordered Shipped B/O Item Number Description Unit Price UOM Ext. Price
1 1 0 915239 -33 GUAGE, LIQUID FILLED, 30 TO 600 50.18 EACH 50.18
PSI
WHITE FACED
1 1 0 91553940 3.5 GAUGE 78.89 78.89
1 1 0 I -S- 253094 -002 SWITCH FOR TILT COLUMN 120.63 EACH 120.63
2 2 0 03910010 SWITCH CAP, LATCHING, 1 LED, 2.86 5.72
BLACK
1 1 0 03210072 PANEL, SWITCH, 2 POSITION 201.00 201.00
Sales Tax (7.0 $0.00
PRICE DISCREPANCIES, RETURN REQUESTS OR Total
SHIPMENT ERRORS MUST BE REPORTED WITHIN 30 $456.42
DAYS TO RECEIVE CREDIT.
Questions about this invoice? Please call 317- 786 -2268.
O RLEY NOW YOU CAN SHOP ON LINE AT INVOICE
SUVY WWW.DONLEYSAFETY.COM
1718 VILLA AVE. rnone ri goo -c�ou Date Invoice
P.O. BOX 33396 Fax 317 786 -2532
5/15/2009 22142
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
NET30 DG WILL CALL
Ordered Shipped Bio Item Number Description Unit Price UOM Ext. Price
3 3 0 57495000 O RING 3.63 10.89
3 3 0 80018005 LOCK ASSEMBLY 41.39 124.17
1 1 0 S- INBOUND INBOUND FREIGHT FOR SPECIAL 7.78 7.78
ORDER ITEM
Sales Tax (7.0 $0.00
PRICE DISCREPANCIES, RETURN REQUESTS OR Total
SHIPMENT ERRORS MUST BE REPORTED WITHIN 30 $142.84
DAYS TO RECEIVE CREDIT.
Questions about this invoice? Please call 317- 786 -2268.
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))
22247 $718.84
22142 $142.84
22141 $456.42
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. WA RRANT NO.
Donley Safety ALLOWED 20
IN SUM OF
P.O. Box 33396
Indianapolis, IN 46203
$1,318.10
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 22247 42- 370.00 $718.84 1 hereby certify that the attached invoice(s), or
1120 22142 42- 370.00 $142.84 bill(s) is (are) true and correct and that the
1120 22141 1 42- 370.00 $456.42
materials or services itemized thereon for
which charge is made were ordered and
received except
JUN X2009
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund