174253 07/08/2009 CITY OF CARMEL, INDIANA VENDOR: 363018 Page 1 of 1
ONE CIVIC SQUARE CAMPBELL SALES SERVICE CHECK AMOUNT: $183.71
CARMEL, INDIANA 46032 1332 S 8TH STREET
NOBLESVILLE IN 46060 CHECK NUMBER: 174253
CHECK DATE: 7/8/2009
DEPAR TMENT ACCOUNT PO NU I NVOICE NUMBER AMOUNT DESCRIPTION
'651 5023990 6083745 100.77 OTHER EXPENSES
651 5023990 790938 82.94 OTHER EXPENSES
r
796 a6 at�s SERVICE SERVICE ORDER
8TH ST. N o. 6053745
LLE,IN 46060
73$727 DATE IN DATE PROMISED
�q CAMPBELLS SERVICE
1 ENGINE MODEL NO. UIPMENT MANUFACTURER
Address NOBLESVILLE, IN 46060
317 Account TYPE OR SPEC N0. TYPE OF EQUIPMENT
Reg. No. Clerk Forward
1 r SERIAIJCODE N0. EQUIPMENT MODEL N0.
2 PHONE EVENING EQUIPMENT SERIAL NO.
3 ATE/TIME E F PURCHASE
4
5 ZI:RVI F E LIS
1N O DIRTY O DAMAGED O OVERALL VACHINE CONDITION:
6 CONDITION: FRESH O USED O DARK O BURNT O
7 AGE: COOLING FINS CONDITION: CLEAN( DIRTYO CLOGGEDO
g 1 MAJOR CHECK COMPRESSION
9 IL CHECK CARBURETION El
10(
11
12
13
14' 1
15
35 Your t d to Date If Erro, qFou Ret urn at Once SUMMARY
PARTS
QTY. PART NUMBER DESCRIPTION LABOR
2 PICKUP /DELIVERY
SHOP SUPPLIES/
ENVIRON. FEES
C GAS OIL
FREIGHT U
SUBTOTAL
TAX
TOTAL
While the manufacturer may warrant the goods sold to the
customer, we make no warranties, express or implied, includ-
ing any implied warranties of merchantability or fitness, with
respect to such goods.
Not responsible for loss or damage in case of fire, theft or any other
cause beyond our control.
1 hereby authorize the above repair work to be done along with the
TOTAL D necessary material and hereby grant you and/or your employees
permission to operate the unit as necessary for the purpose of testing
I FULLY UNDERSTAND THE PURPOSES OF THE SAFETY DEVICES ON THIS EQUIPMENT AND SPECIFICALLY REQUEST THAT THEY and /or inspection. An express mechanic's lien is hereby acknowl-
NOT BE REP IRED OR REPLACED, UIA E RES P SIBILITY F R AND HOLD YOU HARMLESS FROM ANY INJURY TO edged on above unit to secure the amount of repairs thereto.
ANYON TH MAY R T
X Gt 1 l X
AUTHORIZED SIGNATURE AUTHORIZED SIGNATURE,
PRINTED IN U.S.A. COPYRIGHT 2003 BRIGGS STRATTON CORPORATION PART NO. 273188-9/03
i
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
363018
CAMPBELL SALES SERVICE Purchase Order No.
1332 S 8TH STREET Terms
NOBLESVILLE, IN 46060 Due Date 6/29/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/29/2009 790938 $82.94
hereby certify that the attached invoice(s), or bill(s) is (are) true and
;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date 6ff 4rr
VOUCHER 095920 WARRANT ALLOWED
363018 IN SUM OF
CAMPBELL SALES SERVICE
1332 S 8TH STREET
NOBLESVILLE, IN 46060
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
790938 01- 7202 -06 $82.94
bp53�Y5 ol. ?�d� '0 o,77
I lb
Voucher Total $82:94
Cost distribution ledger classification if
claim paid under vehicle highway fund