212409 08/28/2012 CITY OF CARMEL, INDIANA VENDOR: 00350735 Page 1 of 1
ONE CIVIC SQUARE BOB VANVOORST
CARMEL, INDIANA 46032 23402 MULE BARN ROAD CHECK AMOUNT: $322.45
� + SHERIDANIN 46069
„a a� CHECK NUMBER: 212409
CHECK DATE: 8128/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 322 .45 REPAIR PARTS
MAIN OFFICE/Cleveland Cleveland PSD Cadiz Upper Sandusky Toledo
° ► 800.837.6200 800.637.5000 800.837.6204 866,424.6446 888.339.4668
440.526.6200 Canton Columbus N. Kentucky Youngstown
Complete Hydraulic 800.837.6207 888,441.4658 888.446.4658 800.837,6203
Service/Bolivar Cincinnati Dayton Zanesville
800.837.6299 888.332.4658 888.330.4658 800.837.6205
CUSTOMER BACKORDER SHIP
CUSTOMER q STORE p
CASH2 0 PING LIST TERMS DOCUMENT NO.
2 0 *C.O.D* 200095043A
7!! LE—CLEV PSD cu .NU R TO: CARMEL FIRE DEPT FILLED BY
CASH2O 2 CIVIC SQUARE
CARMEL, INDIANA 46032 W/C LOC
STORE
20 WIC PC/S
ORDERED BY TELEPHONE COST. ORDER NO. INSTRUCTIONS DELIVERY LOCATION SHIP VIA
r,4 qKE P/C MODEL SERIAL NO. EQUIP. NO. ARRANGEMENT NO. DATE TIME ENTERED BY REFERENCE NO. PAGE
s.
ITEM ----QUANTITY--- NET
NO. ORDER SHIP B/O PART NUMBER LOCATION N/R TR SOS WEIGHT UNIT PRICE EXTD PRICE
PARTS SALES PERSON: DANIEL VETOVITZ CLEPSD PT
1 2 2 177277CN38 VDR ., 62 CRI . 0 135 . 75 271 . 50
BOTTOM CUSHION
MSC 1 UPS ; .:; . 0 49 . 95 49 . 95
MSC 1 FITS FUEL SURCHRG . 0 1 . 00 1 . 00
EST. TOTAL NET WEIGHT OF SHIPPED ITEMS . 0
SEE PARTS RETURN POLICY ON BACK OF DOCUMENT
TAX EXEMPT LIC # 0031201550-020
SELL TOTAL 322 .45
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AUG 1 6 Zo12.
By (h 5 A.
CITa2I OHIO CAT FARM DOCISMP LIST V t.3
REFER TO BACK PAGE FOR Ohio CAT PARTS RETURN POLICY RECEIVED BY DATE
Account Activity
®�
CREDrr CARD (...
Trans Date Post Date Type Description Amount
Q 08/16/2012 08/192012 Sale OHIO CAT $322.45
BROADVIEW HEI,OH 441470000 US
Online,Mail,or Telephone transaction
812012012 5'•39 Pn
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1 �Y
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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))
E45, E40 $322.45
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
Bob VanVoorst IN SUM OF $
$322.45
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I I 42-370.00 I $322.45 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 272012
iv
v
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund