179848 11/24/2009 CITY OF CARMEL, INDIANA VENDOR: 363603 Page 1 of 1
ONE CIVIC SQUARE SKF LUBRICATION SYSTEMS USA CHECK AMOUNT: $69.27
CARMEL, INDIANA 46032 2115 ALUMINUM AVENUE
HAMPTON VA 23661 CHECK NUMBER: 179848
CHECK DATE: 11/24/2009
DEPARTMEN AC COUNT PO NU MBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 373802 69.27 REPAIR PARTS
$KF Lubrication Systems USA, Inc. INVOICE Date: 11/13/09
1 2115 Aluminum Avenue
Hampton, VA 23661 Invoice No. 373802
Tel. (757) 951 -0370 Sales Order No. 208277
Fax.(757) 951 -0369
vogel @vogel- lube.com www.skf.comllubrication Order Received Date: 11/12/09
Delivery Date: 11/12/09
Customer: 003451 Customer PO No: BOB VAN VOORST
Contact: PH: 317-571-2600 FX: 317 571 -2615
CARMEL, IN, CITY OF
FIRE DEPARTMENT
2 CIVIL SQ
CARMEL, IN 46032 Mode of Dispatch: UPS
Delivery Address: CARMEL, IN, CITY OF
Sales Administrator: Sue Howes /FC FIRE DEPARTMENT
Terms of Payment: N /30 2 CIVIL SQ
CARMEL, IN 46032
Line Stock Item Description Qty O r d ered Qty Shipped Line Ship Date Units Price /Unit Amount
1 504- 20OK -V1 -VS 6 6 11/12/09 EA 10.71 64.26
QUICK CONN, ELBOW, 1 /4- 28,4MM
Amount of Goods Sales Tax Shipping Handling Invoice Total USD
64.26 0.00 5.01 0.00 69.27
Invoice No: 373802
Print Date: 11/13/2009
The Terms of Sale and Delivery of SKF Lubrication Systems USA, Inc. shall apply.
copy available upon request. A FINANCE CHARGE of 1 1/2% PER MONTH is assessed on
all invoice amounts over set terms. This is equivalent to an ANNUAL PERCENTAGE RATE
OF EIGHTEEN PERCENT (18 SEE TERMS COND. RO INV.DOC 09/02
Page 1 of 1
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))
373802 $69.27
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
SKF Lubrication Systems USA
IN SUM OF
2115 Aluminum Avenue
Hampton, VA 23661
$69.27
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# /Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 373802 42- 370.00 $69.27 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
NOV 2 3 2009
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund