180866 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 178450 Page 1 of 1
ONE CIVIC SQUARE KUSSMAUL ELECTRONICS CO IN CHECK AMOUNT: $115.41
4�f CARMEL, INDIANA 46032 170 CHERRY AVE
WEST SAYVILLE NY 11796 -1221 CHECK NUMBER: 180866
CHECK DATE: 12/30/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 89010 115.41 REPAIR PARTS
ACCOUNT NO CUSTOMER ORDER NO SALESPERSON TERMS SALES ORDER
CAR033 R45 RALPH LINDGREN NET 30 DAYS 254261
(9RDERDATE F.OB. POINT SHIPA DATE?SHIPPED >�10. AACKAGES
12/07/09 W.SAYVILLE UPS GROUND SERVICE 12/07/09 1
QTY ORDERED PART NUMBER DESCRIPTION SERIAL NO, UNIT >PRICE NET PRICE AMOUNT
1 091- 74 -IND 108.00 108.00 108.00
AUTO CHARGE D2, INDICATOR
SHIPPING TRACKING
1Z1335780321136826
PLEASE WRITE INVOICE NUMBER ON ALL PAYMENTS SUBTOTAL 108. 00
NO RETURNS ON C.O.D. SHIPMENTS OR ANY SHIPMENTS UNDER $50.00 SHIPPING HANDLING 7.41
ALL RETURNS SUBJECT TO 10% RESTOCKING CHARGE TAX .00
ABSOLUTELY NO RETURNS AFTER 30 DAYS
ALL PAYMENTS IN U.S. DOLLARS ORIGINAL :INVOICE TOTA OTA
$115.41
PLEASE PAY THIS AMOUNT-----
HOME OF THE A UTO CHARGE A UTO EJECT AIR EJECT A UTO PUMP
Prescribed by State Board of Accounts Citv,_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))
89010 $115.41
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 NO.
ALLOWED 20
Kussmaul Electronics
IN SUM OF
170 Cherry Avenue
West Sayville, NY 11796
$115.41
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 89010 42- 370.00 $115.41 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
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund