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205847 01/31/2012 CITY OF CARMEL, INDIANA VENDOR: 362830 Page 1 of 1 ONE CIVIC SQUARE GIBBS AUTO INTERIORS, LLC CARMEL, INDIANA 46032 18318 US HIGHWAY 31 NORTH CHECK AMOUNT: $125.00 WESTFIELD IN 46074 CHECK NUMBER: 205847 CHECK DATE: 1/31/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4351000 2115 125.00 AUTO REPAIR MAINTEN Gibbs Auto Interiors Invoice 18318 US Hwy 31 N Date Invoice Westfield, IN 46074 1/17/2012 2115 Bill To Ship To CARMEL FIRE DEPT 2 CIVIC SQUARE CARMEL, IN 46032 P.O. Number Terms Rep Ship Via F.O.B. Project 1/17/2012 Quantity Item Code Description Price Each Amount Convertibles Labor HOSE COVER REPAIR 125.00 125.00 7.00% 0.00 Total $125.00 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)) 2115 $125.00 1 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 Gibbs Auto Interiors IN SUM OF 7201 E. 86th Street Indianapolis, IN 46250 $125.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. I ACCT #/TITLE AMOUNT Board Members 1120 I 2115 I 43- 510.00 I $125.00 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 JAN 3 0 2012 Y v Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund