180008 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 355831 Page 1 of 1
•i
ONE CIVIC SQUARE BRICKYARD INTERNATIONAL CHECK AMOUNT: $25.54
CARMEL, INDIANA 46032 5730 FORTUNE CIRCLE DR W
INDPLS IN 46241 CHECK NUMBER: 180008
CHECK DATE: 12/8/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 8258577 25.54 REPAIR PARTS
BRI INVOICE DATE
11/19/2009 08:53AM
B" INTERNATIONAL TRUCKS 5730 FORTUNE CIRCLE DRIVE WEST INVOICE NO. PAGE
8258577 1
INDIANAPOLIS IN 46241 CUSTOMER NO. BRANCH
IDEALEASE 317 247 -6631 04001 8*
REMIT TO: BRICKYARD INTERNATIONAL TRUCKS, 5730 FORTUNE CIRCLE WEST, INDIANAPOLIS,'�IN 46241
CITY OF CARMEL INDIANA CITY OF CARMEL INDIANA
SOLD CARMEL FIRE DEPT SHIP CARMEL FIRE DEPT
TO: 2 CIVIC SQUARE TO: 2 CIVIC SQUARE
CARMEL IN 46032 CARMEL IN 46032
Tax id: 0031201550020
CUSTOMER P.O. REFERENCE NO.
A42 A44 873338 (317) 571 -2600 75 000/75 000
PRICE/PER I EXTENSION
TERMS: (00) DUE BY 10TH
2 100 2039390C3 CAP 15.88 12.77EA 25.54
ASK ABOUT OUR BRAKE DRUM
SPECIALS
STATEMENT OF DISCLAIMER: The factory warranty
constitutes all of the warranties with respect to the sale of (1) The account is due and payable in TERMS STRICTLY CASH UNLESS ARRANGEMENTS MADE
this iternAtems. The Seller, BRICKYARD INTERNATIONAL full by the 10th of the month following I hereby authorize the repair work herein set forth to be done along with the
purchase. necessary material and agree that you are not responsible for loss or damage
TRUCKS and IDEALEASE, hereby expressly disclaims all p to vehicle or articles left in vehicle In case of fire, theft or any other cause beyond
(2) Accounts past due are subject our control or for an del caused b unavailabili of arts or delays in
warranties, either express or implied, including any implied Y Y Y Y Y P Y parts
to a delinquency charge of 18 (per annum) shipments byy the supplier or transporter. I hereby grant you and/or our employees
warranty of merchantability or fitness for a particular on the outstanding balance. In the event permission fo operate the vehicle herein described on streets, hlgf ways or 2T
purpose, and BRICKYARD INTERNATIONAL TRUCKS and the account is referred for collection, it is where for the purpose of testing and/or inspection. An express garage keepers lien
IDEALEASE, neither assumes nor authorizes any other agreed that the balance due includes all is hereby acknowledged on above vehicle to secure the amount of repairs thereto,
person to assume for it any liability in connection with collection costs including a reasonable I understand that pursuant to said express garage keeper's lien, I have no right of
the sale of this item /items. attorney fee. possession of this vehicle until the repairsthereto have been paid in full or until
y ou and/or your employees have voluntarily released the vehicle 10 me.
FREIGHT SUBTOTAL TAX STATUS/STATE SALES TAX PLEASE PAY
25.54 EXEMPT IN 0.00 25.54
CUSTOMER TERMS
Customer Approval for repairs not covered by warranty, policy, or field SIGNAT
charges. All parts installed are new unless specified otherwise. x
Prescribed by State Board of Accounts City Form No. 201 (3;w. 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))
8258577 $25.54
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 N
ALLOWED 20
Brickyard International Trucks
IN SUM OF
5730 Fortune Circle Drive
Indianapolis, IN 46241
$25.54
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 8258577 42- 370.00 $25.54 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
DEC 7 2009
ff f3 t��
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund