HomeMy WebLinkAbout214139 10/23/2012 a CITY OF CARMEL, INDIANA VENDOR: 354683 Page 1 of 1
ONE CIVIC SQUARE E M S A R INDIANA
CARMEL, INDIANA 46032 6745 PAYNE ROAD CHECK AMOUNT: $785.12
s�tiori�,. INDIANAPOLIS IN 46203 CHECK NUMBER: 214139
CHECK DATE: 10/23/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 SI-11770 785 . 12 OTHER CONT SERVICES
EMSAR Indiana
6745 E.Payne Rd. ���®�Ce
Indianapolis, IN 46203
(317)213-5262 Customer Number Date Invoice Number
(317)357-1059 Fax 00052 10/4/2012 1 ISI-11770
Bill To: Ship To:
Carmel Fire Department/24 Carmel Fire Department/24
Carmel Fire Department 2 Civic Square Attn: Carmel Fire Department
Accounts Payable 2 Civic Square
Carmel, IN 46032 Attn: Accounts Payable
Carmel, IN 46032
Ship Via Terms Due Date Sales Rep Customer PO Original Order Number
UPS Ground Due on Receipt ?0!4!2012
[SRI 90033 —�
Item No Qty B/O Ship Description Sales Price Disc Total
PM-STRYKER 4 0 4 PREVENTIVE MAINTENANCE-STRYKER 125.00 0% 500.00
EMS
PM-STRYKER 2 0 2 PREVENTIVE MAINTENANCE-STRYKER 90.00•- 0% 180.00
EMS
0004-508-000 4 0 4 SCREW,10-321-5/8" BHCS 1.90 0% 7.60
6080-145-002 2 0 2 X-FRAME GUARD,LOWER 35.22 0% 70.44
0946-001-155 2 0 2 BUMPER 3.14 0% 6.28
0016-003-000 4 0 4 NYLOCK NUT,#10-32 1.65 0% 6.60
0025-133-000 2 0 2 RIVET,3/16 X 3/8 DOME HEAD 1.10 0% 2.20
MILEAGE-STIR 24 0 24 MILEAGE-STRYKER EMS 0.50 0% Q 12.00
EMS
Total Item Count: 8 Total Items Shipped: 44
Subtotal: 785.12
Freight: 0.00
Tax: 6.52
Total: 791.64
Amount Due: 791.64
Page 1
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))
SI-11770 $785.12
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
EMSAR Indiana
IN SUM OF $
6745 Payne Road
Indianapolis, IN 46203
$785.12
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I SI-11770 I 43-509.00 I $785.12 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
ou 2 2 2012
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund