214408 11/07/2012 CITY OF CARMEL, INDIANA VENDOR: 355226 Page 1 of 1
ONE CIVIC SQUARE PUBLIC SAFETY CENTER,INC CHECK AMOUNT: $164.60
CARMEL, INDIANA 46032 8248 W DOE AVENUE
VISALIA CA 93291 CHECK NUMBER: 214408
CHECK DATE: 11/7/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 5367894 164 . 60 SPECIAL DEPT SUPPLIES
INVOICE
INVOICE
Zb1kS*tyCwter
5367894
8248 West Dose Ave.
Visalia, CA 93291 Invoice Date Page
Phone: 1,866.646.4434 10/19/2012 149 of 166
www.publicsafetycenter.com ORDER NUMBER
1223938
Bill To: Ship To:
Cannel FD Carmel FD
ATTN: ACCOUNTS PAYABLE ATTN: MARK HULETT
2 CIVIC SQ. 2 CIVIC SQ.
Cannel, IN 46032 Cannel, IN 46032
US US
Customer ID: 152610
PO Number Tertns Description Net Due Date Disc Due Date Discount Ainount
Net 30 11/18/2012 11/18/2012 0.00
Order Date Pick Ticket No Job No Freight Printarh Salesrep Nante Taker
10/19/2012 3231388 00640000000XQ55A HPrepay and Add Harriett Keys Automated Service
tt. "t� /tern/D /tear Description L/Oi1t Unit Ext7,,d,,d
Or Bred Shrpped P Unit Si.,e Price
Delivery Instructions: FREIGHT OUT
Carrier: UPS-Ground Tracking#:IZ82X74XO358604124
50 50 65001 Triangular Bandage Non Sterile W/Pins EA 1.0000 0.5900 29.50
1 1 MESBC-14016N Cab First Response Bag.Navy EA 1.0000 29.9900 29.99
l 1 MESBC-14016OR Cab First Response Bag,Orange EA 1.0000 29.9900 29.99
3 3 MESBC-SHOOIB Shears,EMS,Black EA 1.0000 2.4900 7.47
3 3 MESBC-SH002BL Shears,EMS.Blue EA 1.0000 2.4900 7.47
3 3 MESBC-SH004Y Shears,EMS.Bright Yellow EA 1.0000 2.4900 7.47
3 3 MESBC-SH006G Shears,EMS,Green EA 1.0000 2.4900 7.47
3 3 MESBC-SH003P Shears,EMS,Hot Pink EA 1.0000 2.4900 7.47
3 3 MESBC-SH0080 Shears,EMS.Orange EA 1.0000 2.4900 7.47
3 3 MESBC-SH007PR Shears,EMS.Purple EA 1.0000 2.4900 7.47
3 3 MESBC-SH005R Shears,EMS,Red EA 1.0000 2.4900 7.47
Total Lines: 11 SUB-TOTAL: 149.24
Total weight In: 0.00 Total Freight Out: 15.36 TOTAL FREIGHT: 15.36
TAX: 0.00
AMOUNT DUE: 164.60
ORIGINAL
VOUCHER NO. WARRANT NO.
ALLOWED 20
Public Safety Center
IN SUM OF $
8248 W. Doe Avenue
Visalia, CA 93291
$164.60
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
1120 I 5367894 1 102-390.11 I $164.60 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 2012
! fin
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor 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 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))
5367894 $164.60
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