HomeMy WebLinkAbout210405 07/05/2012 CITY OF CARMEL, INDIANA VENDOR: 358402 Page 1 of 1
ONE CIVIC SQUARE I D S
CARMEL, INDIANA 46032 2717 TOBEY DRIVE CHECK AMOUNT: $676.35
INDIANAPOLIS IN 46219 CHECK NUMBER: 210405
CHECK DATE: 7/5/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350900 125049 676.35 OTHER CONT SERVICES
nvoice /Contract
19y ofCarmel NT RETURNED
Page 1
rk TIME M
I� CustomerNo.: CITCAR -IN
2717 Tobey Dr 317- 545 -0665 R SIGNATU Invoice No.: 125049
Indianapolis, IN 46219 317 545 -0670 Fax
e ee)
Bill To: City of Carmel y of Carmel
3400 W. 131 st Street 3400 W. 131 st Street
Westfiel d, IN 46074 Westfield, IN 46074
Date Ship Via F.O.B. Terms
06119/12 Will call Origin Net 30
Purchase Order Numb Order Date Account Representative Our Order Number
Verbal i 06/19/12 John Heinzelman i 52945
Quantity_ Item Number Description Unit Price Amount
Required i Shipped
1.000 1.000 ZRE -6.5 PKG C 6.5 cu ft Blast pot w/ 50' 250.0000 250.00
hose, moisture separator,
Helmet, 41P2
1.000 1.000 ZRE- D375QH7JDA (5) 375 CFM Portable Diesel Air 300.0000 300.00
Compressor
S/N 72304
1.000 1.000 ZRE -MWC 10% Maintenance Waiver 55.0000 55.00
Two Day Rental
6 -19 -12 6 -20 -12
1 1 232 -2145 Airline Filter Replacement 30.7000 30.70
Cartridge Flanged
Invoice subtotal 635.70
Sales tax 7.000% 40.65
Invoice total 676.35
DATE AND
Maintenance Waiver Charge (MWC) TIME DUE IN:
10% of Rental Charge, Lesse may, by Initials hereon,
Decline benefits of Paragraph 13, Maintenance Waiver, PROMPT RETURN OF YOUR RENTAL SAVES YOU
on reverse side of Contract MONEY, ALL TIME IS CHARGED INCLUDING
SATURDAY, SUNDAY AND HOLIDAYS.
Declines
DATE AND EQUIP OC
MWC is not insurance TIME RETURNED: HOURS (p t vv
(INITIALS) DATE AND EQUIP
TIME OUT: HOURS V v
I have read and understand the terms and conditions on both sides of this agreement and certify that those printed on the other side THE PRICES
are agreed to as if printed above my signature. There are no oral or other representations not included herein. Unless declined, 1 LISTED ARE AN
agree to :he maintenance waiver charges. 1 have received a copy of this agreement. In the event Lessor brings suit to recover
payments dud, then in addition to any other amount Lessor shall be entitled to receive, it shall be entitled to recover all costs and ESTIMATE." "FINAL
attorney fees incurred in pursuing collection. AMOUNT WILL BE
Lessee's Sigtature: Print: CALCULATED AT
CLOSING OF
Lessee's Drivers License Number. yf�d r O 7 V CONTRACT 'i
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))
06/19/12 125049 $676.35
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
IDS Blast
IN SUM OF
2717 Tobey Drive
Indianapolis, IN 46219
$676.35
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
2201 I 125049 I 43- 509.001 $676.35 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
L o ursd une 28, 2012
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Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund