178787 10/28/2009 CITY OF CARMEL, INDIANA VENDOR: 358990 Page 1 of 1
f ONE CIVIC SQUARE MUNICIPAL EMERGENCY SERVICES CHECK AMOUNT: $88.00
CARMEL, INDIANA 46032 DEPOSITORY ACCOUNT
75 REMITTANCE DR STE 3135 CHECK NUMBER: 178787
CHICAGO IL 50675
CHECK DATE: 1 012 812 009
'OEPARTMENT ACCOUNT PO NUMBE INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 127440 88.00 REPAIR PARTS
Invoice
MES Indiana Number 00127440_SNV
6975 Hillsdale Court Date 10/13/2009
olis, IN 46250 Page 1 of 2
Indianapolis, Sales order SO_107753
MUNICIPAL EMERGENCY SERVICES, INC. Requisition
Your ref.
Telephone :(888) 322 -8402 Our ref. AUlrich
Fax 317- 596 -1701 Payment Net 30
Sales Rep kschulthei
Inv Acct 30195
Bill To: Ship To:
CARMEL FD CARMEL FD
2 CARMEL CIVIC SQUARE 2 CARMEL CIVIC SQUARE
CARMEL, IN 46032 CARMEL, IN 46032
GARY CARTER
Item number Description Quantity Unit Unit price Amount
804426 -01 WAIST BELT ASSY(FEMALE 2.00 EA 44.00 88.00
BUCKLE)
Quantity 2.00 Warehouse IN -SRV Location IN -S1
Merchandise S &H Sales tax Total due
88.00 0.00 0.00 88.00 USD
Please remit to:
MES Indiana
Municipal Emergency Services Depository
Account
75 Remittance Drive
Suite 3135
Chicago, IL 60675
Thank You For Your Order
All returns must be processed within 30 days of receipt and require a return authorization number and are subject to a restocking fee.
Custom orders are not returnable.
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))
127440 $88.00
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
VOUCHER NO. WA NO.
ALLOWED 20
MES
IN SUM OF
75 Remittance Drive
Chicago, IL 60675
$88.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #[TITLE AMOUNT Board Members
1120 127440 42- 370.00 $88.00 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 2 6 2 009
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund