208263 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 079150 Page 1 of 1
Q� ONE CIVIC SQUARE DONLEY SAFETY CHECK AMOUNT: $187.90
CARMEL, INDIANA 46032 5546 ELMWOOD AVE
A oN INDIANAPOLIS IN 46203 CHECK NUMBER: 208263
CHECK DATE: 4125/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 33638 187.90 REPAIR PARTS
I) INVOICE
Ulm Please visit us on the web at www.donleysatefy.corn
DATE INVOICE
Phone 317- 786 -2268
5546 Elmwood Ct. Fax 317- 786 -2632
3/23/2012 33638
Indianapolis, IN 46203
BILL TO SHIP TO
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE 2 CIVIC SQUARE
CAR-MEL, IN 46032 CARMEL, IN. 46032
ATTN: BOB VANVOORST
P.O. NO. TERMS SALES ORDER Rep SHIP VIA FOB Order Date
SHOP TOOLS NET30 11369 11 UPS SHIP POINT
Prev. Inv... Ordered Shipped B/O Item Description Unit Price UOM Amount
0 1 1 90638 KNUCKLEHEAD LIGHT W /120V 178.00 178.00
AC FAST PIGGYBACK CHARGER,
YELLOW
I FREIGHT SHIPPING HANDLING 9.90 9.90
PRICE DISCREPANCIES, RETURN REQUESTS OR SHIPMENT Subtotal $187.90
ERRORS MUST BE REPORTED WITHIN 30 DAYS TO RECEIVE
CREDIT.
Questions about this invoice? Please call 317- 786 -2268 Sales Tax (7.0%) $0.00
Total $187.90
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))
33638 $187.90
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Donley Safety
IN SUM OF
5546 Elmwood Court
Indianapolis, IN 46203
$187.90
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. I ACCT #/TITLE AMOUNT Board Members
1120 I 33638 I 42- 370.00 I $187.90 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
APR d
V r
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund