172854 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 362897 Page 1 of 1
I ONE CIVIC SQUARE HACKNEY CHECK AMOUNT: $148.54
®;r CARMEL, INDIANA 46032 911 W 51 H ST
+,,aa PO BOX 880 CHECK NUMBER: 172854
WASHINGTON NC 27889
CHECK DATE: 5/27/2009
DEPART ACC P O NUMBER INVOICE NUMBER AMOUNT DE
1120 4237000 0197903 12.21 REPAIR PARTS
1120 4237000 0197904 136.33 REPAIR PARTS
I
i
f
Hackney
Division of Specialized Vehicles Corporation
i ;911 W 5th St PO Box 880
Washington, NC 27889
PAGE 1 OF
Phone: 252.946.6521 /0 1
R HACKNEY DIVISION
E VT SPECIALIZED VEHICLES CORP
M PO BOX 65150
I INVOICE NUMBER: 0197904
T CHARLOTTE NC 28265
Jr
USA INVOICE DATE: 05/06/09
O YOUR ORDER NO.: VERBAL /BOB VANVOORST
CITY OF CARMEL S POWER TRAIN
Q ATTN: CHIEF KEITH SMITH H' 450 N ENTERPRISE BLVD
L TWO CIVIC SQUARE LEBANON IN 46052
D CARMEL IN 46032 P_ USA
USA
T7 .T
0::. O
ATTN SALESMAN 0100,._
OUR ,iOBi" s GUSFOMER:NO SHI
7 PPED :'.YIA SHIPPED FROM :PAYMENT':TERMS
09E51102 998254 UPS NC NC NET 30
DESCRIPTION QUANTITY UNIT PRICE= AMOUNT
001 802686 UOM =EA CMP=C3A 1.000 35.6200 35.62
YOKE FLANGE 3.88" #1310
NORTH AMERICAN 2 -2 -329
002 802687 UOM =EA CMP=C3A 1.000 58.6400 58.64
YOKE -DF 1.88" BORE W/ .5 11 KEY
NEW PART #31SLF- 1.87 -502
OR USE SPICER# 2 -1- 1323 -3
003 803953 UOM =EA CMP=C3A 4.000 0.3600 1.44
SCREW SOCKET HEAD 3/8 24 X 1.25 GRADE 8
HEX DRIVE BLACK OXIDE
004 1788 UOM =EA CMP=C3A 4.000 1.5582 6.23
STRAP -DOOR 22.50
005 805444 UOM =EA CMP=C3A 40.000 0.4300 17.20
ROLLER -DOOR .95X.40X2.00 SERRATED
PIN LENGTH 2.00
006 3098 UOM =CN CMP=C3A 1.000 6.2400 6.24
LUBRICANT- FREEWAY 15 OZ
FREIGHT FR 1.000 10.9600 10.96
136.33
Total: 136.33
Payments Applied: .00
i
uoic.
CUSTOMER ORIGINAL TQ7AL 136.33
INVOICES NOT PAID WITHIN TERMS ARE SUBJECT TO A 1 1/2% PER MONTH FINANCE CHARGE CURRENCY: US DOLLARS
Hacknev
Division Specialized Vehicles Corporation
i X11 W 5th St PO Box 880 t
Washington, NC 27889
Phone: 252.946.6521 PAGE 1 OF 1
G�
R'
E HACKNEY DIVISION
VT SPECIALIZED VEHICLES CORP
PO BOX 65150
T INVOICE NUMBER: 0197903
CHARLOTTE NC 28265
USA INVOICE DATE: 05/06/09
YOUR ORDER NO.: VERBAL /BOB VANVOORST
S.- CITY OF CARMEL 5, CITY OF CARMEL
O` ATTN: CHIEF KEITH SMITH H ATTN: CHIEF KEITH SMITH
L. TWO CIVIC SQUARE I' TWO CIVIC SQUARE
CARMEL IN 46032 P CARMEL IN 46032
USA USA
T T'
0 O:
ATTN: BOB VAN VOORST 317 664 0958 SALES 0
l:vsivS
09E51101 998254 UPS NC NC NET 30
DESCRIPTION QUANTITY UNIT PRICE: AMOUNT
001 802866 UOM =EA CMP=C30 1.000 5.2800 5.28
SWITCH ROCKER MOMENTARY
FREIGHT F1 1.000 6.9300 6.93
12.21
Total: 12.21
Payments Applied: .00
INVOICE
CUSTOMER ORIGINAL TQTAL 12.21
INVOICES NOT PAID WITHIN TERMS ARE SUBJECT TO A 1 1/2% PER MONTH FINANCE CHARGE CURRENCY: US DOLLARS
Prescribed by State Board of Accounts City Form No. 201 (Ree, 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))
0197903 $12.21
0197904 $136.33
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
,UCHER NO. WARRANT NO.
ALLOWED 20
Hackney
IN SUM OF
P.O. Box 88e
WasHngtum, fie 89
r
$148.54
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 0197903 42- 370.00 $12.21 1 hereby certify that the attached invoice(s), or
1120 0197904 42 370.00 $136.33 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
MAY 2 2 2009
J 7
U
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund