211731 08/14/2012 CITY OF CARMEL, INDIANA VENDOR: 363862 Page 1 of 1
ONE CIVIC SQUARE JASON FORCE CHECK AMOUNT: $163.67
CARMEL, INDIANA 46032 30 SLEEPY HOLLOW COURT
WESTFIELD IN 46074 CHECK NUMBER: 211731
CHECK DATE: 8/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 163 . 67 REPAIR PARTS
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Account Activity Friday,August 10,2012
points Visa XXXXXXXXXXXX6t:
Balance: $
Minimum Payment Due: $0.00
Payment Due Date: 08/06/2012
Posted Transactions
Clot I) Srrrptre�n Amount
0810611012 WESTFIELD°LIGHTING COtlNCWESTFIELD tN". „ K�a 163 67 r N
08/06/2012
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INVOICE
Westfield Lighting Co., Inc. .INVOICE
Branch: 001 .;;006505766
P.O.Box 898 Invoice ffatel Page
Westfield, IN 46074 8/6/2012,1;32:51 1 Of I
ORDER NUMBER
320775
317-896-3033
Bill To: Ship To:
CASH CASH 'O'a
Customer ID: 100056
PO Number Term Description Net Due Date Disc Due Date Discount Amount
FIREDEPT,CARMEL Prox 10 9/10/2012 9/10/2012 0.00
Order Date Pick Ticket No Primary Salesrep Name Taker
8/6/2012 15:13:33 327895 House Accounts MARK.HUTSON
Quantities Pricing I
Item ID u0m unit Extended
u0m Item Description Price Price
Ordered Shipped I Remaining I
Unit Size Z Unit Size
Delivery Instructions. 003120550
Carrier: Tracking#:
1.0 1.0 0.0 EA RC MRP-CW+ EA 105.00 105.00
1.0 MARQUIS MOTOR&BLADES 1.0000
1.0 1.0 0.0 EA RC D36-CW EA 13.30 13.30
1.0 361N DOWNROD 1.0000
1.0 1.0 0.0 EA FAN CRL4WH EA 45.37 45.37
1.0 REMOTEFAN LIGHT CONTROL 1.0000
Total Lines: 3 SUB-TOTAL: 163.67
TAX: 0.00
163.67
AMOUNTDUE. 0.00
ORIGINAL
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))
$163.67
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
Jason Force
IN SUM OF $
$163.67
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I I 42-370.00 I $163.67 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
AUG 13 2012
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund