HomeMy WebLinkAbout178199 10/14/2009 a CITY OF CARMEL, INDIANA VENDOR: 131135 Page 1 of 1
ONE CIVIC SQUARE HOOSIER FIRE EQUIPMENT INC
1 CARMEL, INDIANA 46032 4009 MONTDALE PARK DRIVE CHECK AMOUNT: $320.00
VALPARAISOIN 46383 CHECK NUMBER: 178199
«ON
CHECK DATE: 10/14/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351501 0072167 320.00 EQUIPMENT MAINT CONTR
INVOICE PAGE: 1
Hoosier Fire Equipment, Inc. INVOICE NUMBER: 0072167 -IN
4009 Montdale Park Drive INVOICE DATE: 09/24/09
Valparaiso, Indiana 46383
ORDER NUMBER:
ORDER DATE:
(219) 462 -1707 SALESPERSON House
CUSTOMER NO: CARM01
SOLD TO: SHIP TO:
Carmel Fire Department Carmel Fire Department
2 Civic Square 2 Civic Square
Carmel IN 46032 -7543 Carmel IN 46032 -7543
CONFIRM TO:
CUSTOMER P.O. SHIP VIA F.O.B TERMS
OUR DELIVERY Net 10
ITEM NO. UNIT ORDERED SHIPPED BACK ORD PRICE AMOUNT
/SERVICE EACH 1.00 1.00 0.00 320.00 320.00
ANNUAL MAINTENANCE AND REPAIRS ON CUSTOMER'S AMKUS
MODEL 4C -15 COMBI TOOL, SERIAL 499080580 AS
PER ATTACHED
TAXABLE .00
NON- TAXABLE 320.00
NET INVOICE: 320.00
SALES TAX: .00
FREIGHT: .00
INVOICE TOTAL: 320.00
AMKUS SERVICE MAINTENANCE REPORT
Service Technician Name: TROY HARMON Equipment Owner: CARMEL FD
AR or Shop Repair Number: SN584 Station /Location: MS SHOP
Date of Service: 9/2312009
AMKUS POWER UNIT AMKUS CUTTER and COMBINATION TOOLS
Serial Number: Serial Number: 99080580
F -XL General inspection F] Model 25 XKGeneral inspection
F -STD Hydraulic Hose(s) Model 25S X]Torque Center Bolt
F -Mini Pump Couplings Model 25L X❑ Inspect Cutter Blades
F -XL F Hydraulic Fluid F Model 25P X❑ Inspect Friction Plates
-XL Fuel Level XQModel C -15 Clean and Lubricate
GH2S -XL F Motor Oil Level Model 25C
F -Hand Pump Model 21 Model 22
F 101 -Air Pump Maintenance Notes: INSTALLED COMPLETE
Other SEAL KIT LEVEL 3 REBUILD. PERFORMED
Maintenance Notes: ANNUAL SERVICE. SHARPEN BLADES.
REPLACED DECAL AND DUST CAP. TESTED TOOL.
AMKUS HYDRAULIC RAMS
AMKUS HYDRAULIC SPREADER 1-120 -R Serial No.
Serial Number: 30 -R Serial No.
Model 30CX 7General Inspection F -R Serial No.
Model 28 Tool Operation 60 -R Serial No.
Model 24 F Rack Shield General Inspection Rod
Arms Threads Rod End
Tips Clean and Lubricate
Clean and Lubricate Maintenance Notes:
Maintenance Notes:
REPLACEMENT PARTS: ANNUAL MAINTENANCE FEE:
QTY Item No. Description Price Total Labor
1 1400300424001 C -15 SEAL KIT Parts
1 840131001000 DUST CAP Other
1 980771200020 CLOSE /OPEN DECAL Subtotal
2 65EO5600000D CUTTER RETAINING RING Sales Tax
Shipping Handling
TOTAL DUE
t
AMKUS SERVICE MAINTENANCE REPORT
REPLACEMENT PARTS
QTY PART NUMBER DESCRIPTION
1 40030 AM K -C 15 SEAL KIT
1 840131001000/MS DUST CAP
1 980771200020/MS CLOSE /OPEN DECAL
2 65E05600000D /MS CUTTER RETAINING RING
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))
0072167 $320.00
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
VOL!- NO. WARRANT NO.
ALLOWED 20
F�Ioosier Fire Equipment
IN SUM OF
4009 Montdale Park Drive
Valparaiso, IN 46383
$320.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 0072167 43- 515.01 $320.00 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
OCT 12 2009
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund