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172295 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 079150 Page 1 of 1 0 ONE CIVIC SQUARE DONLEY SAFETY CHECK AMOUNT: $202.50 CARMEL, INDIANA 46032 P 0 BOX 33396 INDIANAPOLIS IN 46203 CHECK NUMBER: 172295 CHECK DATE: 5113/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4237000 21877 202.50 REPAIR PARTS c Dw NOW YOU CAN SHOP ON LINE AT INVOICE WWW. DONLEYSAFETY. COM 1718 VILLA AVE. rnone Date Invoice# P.O. BOX 33396 Fax 317 786 -2532 4/24/2009 21877 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 1 0 MS100 IOOW SPEAKER 202.50 202.50 Sales Tax (7.0 $0.00 PRICE DISCREPANCIES, RETURN REQUESTS OR Total SHIPMENT ERRORS MUST BE REPORTED WITHIN 30 $202.50 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)) 21877 $202.50 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 Don ey Safety IN SUM OF P.O. Box 33396 Indianapolis, IN 46203 $202.50 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 1120 21877 42- 370.00 $202.50 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 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund