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208723 05/10/2012 CITY OF CARMEL, INDIANA VENDOR: 131135 Page 1 of 1 ONE CIVIC SQUARE HOOSIER FIRE EQUIPMENT INC CARMEL, INDIANA 46032 4009 MONTDALE PARK DRIVE CHECK AMOUNT: $117.41 VALPARAISO IN 46383 CHECK NUMBER: 208723 CHECK DATE: 5/10/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4237000 80341 117.41 REPAIR PARTS INVOICE PAGE: 1 Hoosier Fire Equipment, Inc. INVOICE NUMBER: 0080341 -IN 4009 Montdale Park Drive INVOICE DATE: 04/20/12 Valparaiso, Indiana 46383 ORDER NUMBER: 0110343 ORDER DATE: 04/13/12 (219) 462 -1707 SALESPERSON House CUSTOMER NO: CARM01 SOLD TO: SHIP TO: Carmel Fire Department Carmel Fire Department 2 Civic Square 2 Civic Square Carmel IN 46032 -7543 Carmel IN 46032 -7543 CONFIRM TO: CUSTOMER P.O. SHIP VIA F.O.B TERMS UPS OVERNITE Net 10 ITEM NO. UNIT ORDERED SHIPPED BACK ORD PRICE AMOUNT /SORDER EACH 1.00 1.00 0.00 75.00 75.00 #P1744000, SEAGRAVE LOW COOLANT LEVEL SENSOR TAXABLE .00 NON TAXABLE 75.00 NET INVOICE: 75.00 SALES TAX: .00 FREIGHT: 42.41 INVOICE TOTAL: 117.41 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)) 80341 $117.42 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 Hoosier Fire Equipment IN SUM OF 4009 Montdale Park Drive Valparaiso, IN 46383 $117.4? ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO# Dept. INVOICE NO. ACCT #/TITLE I AMOUNT Board Members 1120 I 80341 I 42- 370.00 I $117.44 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 MAY 7 2012 Fire Ch Title Cost distribution ledger classification if claim paid motor vehicle highway fund