213915 10/23/2012 CITY OF CARMEL, INDIANA VENDOR: 359513 Page 1 of 1
0 ONE CIVIC SQUARE FIRE SYSTEMS SERVICES INC
CARMEL, INDIANA 46032 1424 SADLIER CIRCLE E DR CHECK AMOUNT: $200.00
INDIANAPOLIS IN 46239
CHECK NUMBER: 213915
CHECK DATE: 10/23/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 S12-5078 200 . 00 CONT SERVICES OTHER
FIRE SYSTEMS SERVICES, INC. Invoice
1424 Sadlier Circle E. Drive
Indianapolis, IN 46239 DATE INVOICE#
(317) 375-4390
10/15(2012 512-5078
(3)17) 375-4391 FAX
BILL TO SHIP TO
City of Carmel Wastewater Utilities Carmel Water Ops Facility
Accts Payable
3450 West 131st Street
Westfield,IN 46074
iLp
P.O. NO. TERMS PROJECT/JOB
Net 15 days
QTY DESCRIPTION RATE AMOUNT
Observed Quarterly Fire Sprinkler Testing and Inspection.
200.00 200.00
0.00% 0.00
Thank you for your business.
Total $200.00
VOUCHER # 122442 WARRANT # ALLOWED
359513 IN SUM OF $
FIRE SYSTEMS SERVICES INC
1445 BROOKVILLE WAY, SUITE D
INDIANAPOLIS, IN 46239
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
S12-5078 01-6360-06 $200.00
Voucher Total $200.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
359513
FIRE SYSTEMS SERVICES INC Purchase Order No.
1445 BROOKVILLE WAY, SUITE D Terms
INDIANAPOLIS, IN 46239 Due Date 10/17/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/17/201: S12-5078 $200.00
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
Date Officer