214290 11/07/2012 CITY OF CARMEL, INDIANA VENDOR: 00350874 Page 1 of 1
ONE CIVIC SQUARE FIFTH THIRD EQUIPMENT FINANCE CO CHECK AMOUNT: $28,710.68
CARMEL, INDIANA 46032 PO BOX 630756
CINCINNATI OH 45263-0756 CHECK NUMBER: 214290
CHECK DATE: 11/7/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4356003 486244 28, 710 . 68 SAFETY ACCESSORIES
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ENVLIECE STATEMENT ?AYMEN;T
NUNEBER GUSTO(VIER NUfVIBER TOTAL PAYMENT DUE
DATE DUE DATE
00000486244 0000003962 10/17/12 12/01/12 28,710.68
DUE DATE DESCRIPTION: CURRENT DUE AMOUNT PAID TOTALS :
LEASE NO. 093-0054295-232
FIRE SUITS
12/01/12 RENTAL 28,710.68 28,710.68
MONTH CURRENT
RENI:AL DUE::;
T AXES DUE':: .. MISC CHARGES:DU£ LATE CHARGES DUE:TDTgL<CURRENT .PAYMENTS DtJE
28,710.68 .00 .00 .00 28,710.68
1 30'.DAYS' > i 31-8Q:3?AYS. :;: 67-4Di DAY5i,,:i 9.1'DAYS.& OVER
TOTAL PAYMENTS DUE
.00 .00 .00 .00 28,710.68
For customer inquiries please call (800)998-3444 extension 6770.
RETAIN THIS PORTION FOR YOUR RECORDS
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))
486244 $28,710.68
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
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
Fifth Third Bank ALLOWED 20
IN SUM OF $
P.O. Box 630756
Cincinnati, OH 45263-0756
$28,710.68
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I 486244 I 43-560.03 I $28,710.68 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
NOV - : 2012
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund