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170893 04/16/2009 CITY OF CARMEL, INDIANA VENDOR: 362748 Page 1 of 1 ONE CIVIC SQUARE HOBART CABINET COMPANY CARMEL, INDIANA 46032 PO BOX 458 CHECK AMOUNT: $1,846.72 y;�o TROY OH 45373 CHECK NUMBER: 170893 CHECK DATE: 4/16/2009 DEPARTMENT ACCOUNT P O NUM INVOICE NUMBE AMOUNT D ESCRIPTION 102 4467099 41030 1,846.72 OTHER EQUIPMENT HOBART CABINET COMPANY INVOICE 301 EAST WATER STREET P. O. BOX 458 TROY, OH 45373 41030 PH: 937 335 -4666 Apr 8, 2009 FAX: 937 335 -4669 1 I THE CARMEL FIRE DEPARTMENT THE CARMEL FIRE DEPARTMENT ATTN: DENISE SNYDER BRUCE KNOTT 317 571 -2674 2 CIVIC SQUARE 2 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 SHIP VIA CUST I.D. CARMEL UPS FREIGHT i SHIP DATE 4/8/09 P.O. NUMBER VERBAL P. O. DATE DUE DATE 5/8/09 OUR ORDER NO. 40059 TERMS Net 30 Days SALESPERSON MLJ ITEM I.D./DESC. ORDERED SMPPED UNIT PRICE NET A =0690A 2.00 2.00 838.71 1,677.42 8-DRW BP LARGE ALMOND UPS FREIGHT PRO 616039126 878 LBS), PRE -PAY 8s ADD, LIFTGATE I i Freight 169.30 SUBTOTAL: 1_,77.42 TAX P IYMENT 0.00 T TAL 1,846.72 THIS MEMORANDUM' is a n acknowledgment that a Hill of Lading has been Issued and is not the Original Hill of Lading, nor a copy or DESIGNATE WITH AN (X) covering duplicate, c the property named herein, and is Intended solely for filing or record. RECEIVED, subject to the classification and lawfully filed tariffs In effect on the date of receipt by the carrier of the property described in the Original Bill of Lading. BY TRUCK FREIGHT the property deseribed below, in apparent good order, except as noted (contents and condition of contents of packages unknown), marked, consigned and destined as indicated below, which said carrier (the word carder being understood throughout this contract as meaning'any persomor corporation in possession of the property under the contract) agrees to carry,to its usual place of delivery at said destination, if on its route; otherwise to deliver to another carrier on the route to said destination. It is mutually agreed, as. to each carder of all or any of said property over all or-any portion of said route to destination, and as to each parry at any time interested in all or any of said property, that every service io be performed hereunder shall be subject to. all the terms and conditions of shoe Unifosm Domestic Straight Bill of Lading set forth (1) in Uniform Freight Classification in effect on the date hereof, if this is a rail or a rail -water shipment, or(2).in the applicable motor carrier classification or tariff If this is a motor carrier shipment. Shipper hereby certifies that he Is familiar with all the terms and conditions of the said bill of lading, set forth In the classification or tariff which governs the transportation of this shipment, and the sold terms and conditions are hereby agreed to by the shipper and accepted for himself and his assigns. DATE SHIPPER'S NO. From HOBART CABINET CO. ,t I q _Q At 301 E'W Water Strut Troy, OH 45 CARRIER'S NO. Ph. (937) 335"46M Fax (937) 33S46M CARRIER BY r y-- i i r I J .4- Lam' }CONSIGNEE �i I AND S �_N ROUTE DELIVERING CARRIER DESTINATION }�`.�J %I t j" /,s 1 G [i_.. f �(s� 9 CAR OR VEHICLE -T 1 J INITIALS &NO. NO. DESCRIPTION.OF ARTICLES, SPECIAL ERG 'WEIGHT CLASS Subject to Section 7 of Conditions of PACKAGES HM MARKS AND EXCEPTIONS If (SUBJECT TO CORR.) OR RATE applicable bill of lading, it this shipment is to be delivered to the consignee without r y"�,,/"� recourse on the consignor, the consignor !rt 1 L/' shall sign the following statement The carrier shall not make delivery of this shipment 1 without payment of freight u Y� .and all other lawful charges. Per ABC (Signature of Consignor) If charges are to be prepaid, write or r i_J stamp here, 'To be Prepaid' y Received to apply in prepayment of the charges on the property described hereon. Agent or Cashier. SU WITH SOLID WALLS LESS THAN 1" IN THICKNESS Pe DRIVER'S SIGNATURE EMERGENCY RESPONSE PHONE NO. (The signature here acknowledges only PLACARDS SUPPLIED ❑YES ONO the amount prepaid). SHIPPERS CERTIFICATION: This is to cenlry that the above -named materials are properly Charges Advanced: classified, described, packaged, marked and labeled, and are in proper condition for transportation according to the applicable regulations of the Department of Transportation. SIGNATURE TITLE 8 If the shipment moves between two ports by a carrier by water, the law requires that the bill of lading shall state whether it is "carrier's or shipper's weight' C.O.D. SHIPMENT t Shipper's Imprints In lieu of stamp; not a part of Bill of Lading approved by the Interstate Commerce Commission. Note Where the rate is dependent on value, shippers are required to state specifically in writing the agreed or declared value of the property. C.O.D. Amt The agreed or declared value of the property is hereby specifically stated by the shipper to be not exceeding t THIS SHIPMENTIS CORRECTLY DESCRIBED. t The fibre boxes used forthis shipmentoonfonn to the specifications Collection Fee set forth in the box makers certificate thereon, and all other CORRECT WEIGHT IS lgS Irequirements of the Consolidated Freight Classification. Per Shipper Total Charges "r HOBART CABINET CO. Shipper, Per Agent, Per 301 East Water Street Troy, OH 45373 I Permanent post -office address of shipper FORM 12003 REORDER FROM RAPIDFORMS, INC., THOROFARE, NJ 08086 -9499 VOUCHER NO. WARRANT NO. ALLOWED 20 Hobart Cabinet Company IN SUM OF P.O. Box 458 3 Z 8 Troy, OH 45373 $1,846.72 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 1120 41030 102- 670.99 $1,846.72 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 APR 1 2009 r Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund 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)) 41030 Cabinets Insp. $1,846.72 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