214329 11/07/2012 CITY OF CARMEL, INDIANA VENDOR: 366314 Page 1 of 1
ONE CIVIC SQUARE HUGHES SAFETY INC
0 CHECK AMOUNT $268.50
CARMEL, INDIANA 46032 2365 BILL SMITH ROAD
.,_ MARTINSVILLE IN 46151 CHECK NUMBER. 214329
CHECK DATE. 11/7/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 2012-0082 268 50 OTHER CONT SERVICES
HUGHES SAFETY INCORPORATED Invoice
2365 BILL SMITH RD
Date Invoice#
MARTINSVILLE, IN 46151
317-538-7373 10/25/2012 2012-0082
Bill To
CARMEL FIRE DEPARTMENT
BOB VANVOORST
2 CIVIC SQUARE
CARMEL.IN 46032
PO No Terms Project
Net 30
Quantity Description Rate Amount
76 LADDER TEST PER FOOT 1.50 11400
8 HEAT SENSOR INSTALLATION 2.00 16.00
1 LADDER FOOTAGE TAGS.PAIR 2.00 2.00
66 3/16"X 3/16"ROUND HEAD RIVET 0.25 16.50
6 REPAIR DAMAGE TO LADDER BEAM.WELD 1000 6000
r .60 TRIP CHARGE.PER MILE 1 00 6000
Total $268.50
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))
2012-0082 $26850
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
120
Clerk-Treasurer
VOUCHER NO WARRANT NO
ALLOWED 20
Hughes Safety Inc
IN SUM OF $
2365 Bill Smith Road
Martinsville, IN 46151
$26850
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO ACCT#/TITLE AMOUNT Board Members
1120 I 2012-0082 I 43-50900 I $26850 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 _ 5 2917
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund