173017 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 359261 Page 1 of 1
ONE CIVIC SQUARE SAFETY SYSTEMS CHECK AMOUNT: $125.97
CARMEL. INDIANA 46032 4113 TURNER ROAD
RICHMOND IN 47374 CHECK NUMBER: 173017
CHECK DATE: 5/27/2009
DEPARTMENT A CCOU NT PO N INVOICE NUM BER AMOUNT DE SCRIPTION
1120 4237000 905151) 125.97 REPAIR PARTS
407
Safety Systems U IM WO H C
4113 Turner Road
Richmond, IN 47374 Invoice Number: 905151J
Invoice Date: May 15, 2009
Page: 1
Voice: 765- 935 -3566 Duplicate
Fax: 765 -935 -9713
Bill To: Ship to:
carmel fire dept.
2 civic square
Carmel, IN 46032
Customer ID Customer PO Payment Terms
carmel "d. Net 30 Days
Sales Rep ID' Shipping 1Vlethod Ship Date Due Date
UPS Ground 6114109
Quantity item Description Unit PHce• Amount
3.00 36- 0362546 -OOA 40.00 120.00
1.00 shipping 5.97 5.97
Subtotal 125.97
Sales Tax
Total Invoice Amount 125.97
Check /Credit Memo No: Payment /Credit Applied
TOTAL 125.
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))
9051511 $125.97
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. WAR RANT N
ALLOWED 20
Safety Systems
IN SUM OF
4113 Turner Road
Richmond, IN 47374
$125.97
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# I Dept. INVOICE NO. ACCT #ITITLE AMOUNT Board Members
1120 9051511 42- 370.00 $125.97 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
2009
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund