172810 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 079150 Page 1 of 1
ONE CIVIC SQUARE DONLEY SAFETY CHECK AMOUNT: $2,424.42
CARMEL, INDIANA 46032 P 0 BOX 33396
INDIANAPOLIS IN 46203 CHECK NUMBER: 172810
CHECK DATE: 5/27/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4356003 22108 2,424.42 SAFETY ACCESSORIES
D NOW YOU CAN SHOP ON LINE AT INVOICE
aw WWW.DONLEYSAFETY.COM
DATE INVOICE
1718 VILLA AVE. rnone a i resn -�toa
P.O. BOX 33396 Fax 317 786 -2532
5/18/2009 22108
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
ATTN: GARY CARTER
P.O. NO. TERMS SALES ORDER Rep SHIP VIA Order Date FOB
NET30 4730 GH BEST WAY AV... SHIP POINT
Prev. Inv... Ordered Shipped B/O Item Description Unit Price UOM Amount
0 1 1 MISC. 277 0975- LEATHER BUNKER 239.00 239.00
BOOT, W/ TOE CAP ENERSOLE
3 POINT HEEL LOCK,SZ 11.5 XW,
FOR:BRAD SOMBKE
0 1 1 MISC. 277 0975- LEATHER BUNKER 239.00 239.00
BOOT, W/ TOE CAP ENERSOLE
3 POINT HEEL LOCK,SZ 12 WIDE,
FOR:JIM DORSCH
0 1 1 MISC. 277 0975 LEA'T'HER BUNKER 239.00 239.00
BOOT, W/TOE CAP ENERSOLE 3
POINT HEEL LOCK, SZ 11.5 M.
FOR: STEVE WISTKEN
1 FREIGHT SHIPPING HANDLING 34.42 34.42
PRICE DISCREPANCIES, RETURN REQUESTS OR SHIPMENT Subtotal $2,424.42
ERRORS MUST BE REPORTED WITHIN 30 DAYS TO RECEIVE
CREDIT.
Questions about this invoice? Please call 317 786 -2268 Sales Tax (7.0 $0.00
Total $2,424.42
Page 2
DONLEY NOW YOU CAN SHOP ON LINE AT INVOICE
1w WWW.DONLEYSAFETY.COM
DATE INVOICE
1718 VILLA AVE, rnone i r rno -«ou
P.O. BOX 33396 Fax 317 786 -2532
5/18/2009 22108
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
ATTN: GARY CAR'T'ER
P.O. NO. TERMS SALES ORDER Rep SHIP VIA Order Date FOB
NET30 4730 GH BEST WAY AV... SHIP POINT
Prev. Inv... Ordered Shipped B/O Item Description Unit Price UOM Amount
0 2 2 MISC. 277 0975 LEATHER BUNKER 239.00 478.00
BOOT, W/ TOE CAP ENERSOLE
3 POINT HEEL LOCK,SZ 10 WIDE,
FOR:JOHN MORIARTY
BRAD LOVE
0 2 2 MISC. 277 0975 LEATHER BUNKER 239.00 478.00
BOOT, W/ TOE CAP ENERSOLE
3 POINT HEEL LOCK,SZ 10.5
WIDE, FOR:JEFF GRIMES
DAVE MARTIN
0 1 1 MISC. 277 0975 LEATHER BUNKER 239.00 239.00
BOOT, W/ TOE CAP ENERSOLE
3 POINT HEEL LOCK,SZ 1 1 WIDE,
FOR:BILL WORKMAN
0 2 2 MISC. 277 0975- LEATHER BUNKER 239.00 478.00
BOOT W/ TOE CAP ENERSOLE
3 POINT HEEL LOCK,SZ 11.5
WIDE, FOR:BARRY CRANE
CRAIG PHILLIPS
PRICE DISCREPANCIES, RETURN REQUESTS OR SHIPMENT Subtotal
ERRORS MUST BE REPORTED WITHIN 30 DAYS TO RECEIVE
CREDIT.
Questions about this invoice? Please call 317 786 -2268 Sales Tax (7.0
Total
Page 1
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))
22108 $2,424.42
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.
Donley Safety ALLOWED 20
IN SUM OF
P.O. Box 33396
Indianapolis, IN 46203
$2,424.42
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 22108 43- 560.03 $2,424.42 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
MAY 2 2 2
Fire Chief
_.-Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund