170820 04/16/2009 CITY OF CARMEL, INDIANA VENDOR: 079150 Page 1 of 1
0 ONE CIVIC SQUARE DONLEY SAFETY CHECK AMOUNT: $2,608.48
CARMEL, INDIANA 46032 P 0 BOX 33396
•v :oN INDIANAPOLIS IN 46203 CHECK NUMBER: 170820
CHECK DATE: 4/16/2009
DEPARTMENT ACCOUN PO NUMBER INVOICE N AMOUNT DESCRIPTION
1120 4237000 21655 259.32 REPAIR PARTS
:1120 4351000 W3717 1,349.68 AUTO REPAIR MAINTEN
1120 4351000 W3720 406.50 AUTO REPAIR MAINTEN
1120 4351000 W3736 592.98 AUTO REPAIR MAINTEN
NOW YOU CAN SHOP ON LINE AT
Invoice
WWW.DONLEYSAFETY.COM
1718 VILLA AVE. rnone o 1 -1 oo -«oa
Date Invoice
P.O. BOX 33396 Fax 317 -786 -2532
INDIANAPOLIS, IN. 46203 3/31/2009 W3736
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
10579 Due on receipt FS AMB 45 84410 3HTMNAALK3N585816
Item Quantity Description Rate UOM Amount
LABOR 1 LOW OXYGEN ALARM KEEPS GOING OFF. REPLACED 78.00 HR 78.00
PROM
LABOR 0.5 SWITCHES AT FRONT CONSOLE FOR FLORESCENT 78.00 HR 39.00
LIGHTS BROKEN. REPLACED SWITCH PLATE AND
COVERS.
'tvGG548o i EPROM, -1 I 1502, iNTELLIPLEX SYSTEM 24 v: v "v 24.
S- INBOUND 1 INBOUND FREIGHT FOR SPECIAL ORDER ITEM 15.22 15.22
03210072 1 PANEL, SWITCH, 2 POSITION 201.00 201.00
03910010 2 SWITCH CAP, LATCHING, 1 LED, BLACK 2.86 5.72
SHOP I MISC. SHOP SUPPLIES, CLEANING SUPPLIES, ETC. 14.04 14.04
Sales Tax (7.0 $0.00
PRICE DISCREPANCIES, RETURN REQUESTS OR Total $592.98
SHIPMENT ERRORS MUST BE REPORTED WITHIN
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
ONLEY NOW YOU CAN SHOP ON LINE AT INVOICE
SUM WWW.DONLEYSAFETY.COM
1718 VILLA AVE. rnone o i ico -«oes Date Invoice
P.O. BOX 33396 Fax 317 786 -2532
3/31/2009 21655
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
1 1 0 040271V TURN SIGNAL TILT SWITCH 157.30 157.30
1 1 0 REPAIR PARTS 018289VO04 WINDOW REGULATOR, 90.00 90.00
LH REAR
1 1 0 SFREIGHT SHIPPING HANDLING 12.02 12.02
Sales Tax (7.0 $0.00
PRICE DISCREPANCIES, RETURN REQUESTS OR Total
SHIPMENT ERRORS MUST BE REPORTED WITHIN 30 $259.32
DAYS TO RECEIVE CREDIT.
Questions about this invoice? Please call 317- 786 -2268.
D ONLEY NOW YOU CAN SHOP ON LINE AT Invoice
aw WWW.DONLEYSAFETY.COM
Date Invoice
1718 VILLA AVE. rnone si- ioo -«oa
P.O. BOX 33396 Fax 317 -786 -2532
INDIANAPOLIS, IN. 46203 3/31/2009 W3717
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
5016 Due on receipt FS ENG 41 50574 1 K9AF42822N058489
Item Quantity Description Rate UOM Amount
CHASSIS 1 CHASSIS SERVICE: ALSO ROTATED STEERING "TIRES. 225.00 225.00
LABOR 6.5 REBUILT AUTO LUBE. HAD TO REMOVE VALVES 78.00 HR 507.00
AND MANIFOLD PLUMBING TO GET TO AUTO LUBE.
57746XD I OIL FILTER 36.60 36.60
546- 1570 -00 1 LUBE KIT 140.44 140.44
15W40 OIL 8 15W40 OIL 11.94 95.52
60A00TAR 2 600 LED ARROW, AMBER 102.04 204.08
REPAIR PARTS 2 6EHDL "IMK KIT 21.60 43.20
HAZMAT FEE I HANDLING AND DISPOSAL OF HAZARDOUS 10.00 10.00
MATERIALS
SHOP 1 MISC. SHOP SUPPLIES, CLEANING SUPPLIES, ETC. 87.84 87.84
Sales Tax (7.0 $0.00
PRICE DISCREPANCIES, RETURN REQUESTS OR Total $1.349.68
SHIPMENT ERRORS MUST BE REPORTED WITHIN
30 DAYS TO RECEIVE CREDIT. If you have questions
about this invoice, Please call Debra O'Dair n
317- 786 -2268 or email to dodair @donleysafety.com
ORLEY YOU CAN SHOP ON LINE AT Invoice
WWW. DONLEYSAFETY. COM
JDS 1718 VILLA AVE. rnone a i l- ruo �[oa
Date Invoice
P.O. BOX 33396 Fax 317 -786 -2532
INDIANAPOLIS, IN. 46203 3/31/2009 W3720
Bill To Service Info
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE 2 CIVIC SQUARE
CAR-MEL, IN. 46032 CARMEL, IN. 46032
S.O. No. Terms Rep Vehicle Mileage VIN
10579 Due on receipt FS AMB45 84410 3HTMNAALX3N585816
Item Quantity Description Rate UOM Amount
AMBULANCE 1 AMBULANCE SERVICE; OIL AND OIL FILTER ONLY 175.00 175.00
LABOR 1 REPLACED ROOF VENTS WITH CUSTOMER SUPPLIED 78.00 HR 78.00
VENT
51799 1 OIL FILTER 23.59 23.59
1 5W40 OIL 7.5 15W40 OIL 11.94 89.55
HAZMAT FEE "1 HANDLING'AND DISPOSAL OF HAZARDOUS 10.00 10:00
MATERIALS
SHOP I MISC. SHOP SUPPLIES, CLEANING SUPPLIES, ETC. 30.36 30.36
Sales Tax (7.0 $0.00
PRICE DISCREPANCIES, RETURN REQUESTS OR Total $406.50
SHIPMENT ERRORS MUST BE REPORTED WITHIN
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))
W3736 Repair A45 $592.98
W3720 PM A45 $406.50
W3717 PM E41 $1,349.68
21655 Misc. Repair Parts $259.32
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
$2,608.48
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 W3736 43- 510.00 $592.98 1 hereby certify that the attached invoice(s), or
1120 W3720 43- 510.00 $406.50 bill(s) is (are) true and correct and that the
1120 W3717 43- 510.00 $1,349.68
materials or services itemized thereon for
1120 21655 42- 370.00 $259.32
which charge is made were ordered and
received except
APR 13 2
e a
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund