211838 08/14/2012 CITY OF CARMEL, INDIANA VENDOR: 178450 Page 1 of 1
ONE CIVIC SQUARE KUSSMAUL ELECTRONICS CO IN
CARMEL, INDIANA 46032 170 CHERRY AVE CHECK AMOUNT: $144.08
WEST SAYVILLE NY 11796-1221 CHECK NUMBER: 211838
CHECK DATE: 8/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 63374 144 . 08 REPAIR PARTS
M
WKU S S M A U L INVOICE 63374
ELECTRONICS CO., INC.
170 CHERRY AVENUE WEST SAYVILLE, NY 11.796-1221 USA, Page;; Date
TEL: 631-567-0314, FAX: 631-567-5826, www.kussmaul.com, sales@kussmaul.com 1 7/26/12
Sold to: Snip to:
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL IN 46032 CARMEL IN 46032
_ ACCO.UNT.NO. CUSTOM.ER ORDER NO. :: SALESPERSON'-: TERMS'.',,... . SALES.ORDER
CAR033 JASON FORCE RALPH LINDGREN NET 30 DAYS 309567
ORDER DATE: F.O.B.POINT
SHIPPED VIA DATE SHIPPED NO.PACKAGES
7/25/12 W.SAYVILLE UPS GROUND SERVICE 7126112 1
QTY.ORDERED_ PART NUMBER../;;DESCRIPTION SERIAL NO. UNIT PRICE, ;;;:: .NEYPRIC,E! :::_,;: AMOUNT::...::::{?:_
2 091-18-098 66. 29 66. 29 132.58
DYNAMIC DISCONNECT 002670
002671
SHIPPING TRACKING #:
1Z1335780321673326
PLEASE WRITE INVOICE NUMBER ON ALL PAYMENTS SUBTOTAL 132.58
NO RETURNS ON C.O.D. SHIPMENTS OR ANY SHIPMENTS UNDER$50.00 SHIPPING & HANDLING 11 .50
ALL RETURNS SUBJECT TO 10%RESTOCKING CHARGE TAX . 00
ABSOLUTELY NO RETURNS AFTER 30 DAYS A
ALL PAYMENTS IN U.S.DOLLARS ORIGINAL IN:VO ICE:: TOTAL
$144.08
PLEASE PAY THIS AMOUNT------
HOME OF THE A UTO CHARGE-A UTO EJECT-AIR EJECT-A UTO PUMP
VOUCHER NO. WARRANT NO.
Kussmaul Electronics ALLOWED 20
IN SUM OF $
170 Cherry Avenue
West Sayville, NY 11796
$144.08
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT
Board Members
1120 I 63374 I 42-370.00 I $144.08 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
f y E
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Irescribed by State Board of Accounts City Form No.201(Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
Nn invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
vhom, 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))
63374 $144.08
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