214810 11/20/2012 CITY OF CARMEL, INDIANA VENDOR: 359261 Page 1 of 1
_ ONE CIVIC SQUARE SAFETY SYSTEMS CHECK AMOUNT: $748.87
CARMEL, INDIANA 46032 4113 TURNER ROAD
_ RICHMOND IN 47374 CHECK NUMBER: 214810
CHECK DATE: 11/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 12111212 332 .22 REPAIR PARTS
1120 4237000 1211211 416 . 65 REPAIR PARTS
Safety Systems
4113 Turner Road
Richmond, IN 47374 Invoice Number: 12111212
I nvoice Date: Nov 12, 2012
Page: 1
Voice: 765-935-3566 Duplicate
Fax: 765-935-9713
BiILTo , Ship to:
Carmel Fire Dept.
2 Civic Square
Carmel, IN 46032
•';Customer ID •:; Customer PO Payment Terms
Carmel f.d. Net'30-Days-— - —
�
Sales Rep ID .:: $hipping Method Ship Date' ' Due Date;
Hand Deliver 12/12/12
Quantity`: Item;. Description Unit Price',.',,' Amount
2.00 C-TC&2 Computer Mounting 110.25 220.50
2.00 C-MD-202 Computer Swing Arm 55.86 111.72
Subtotal 332.22
Sales Tax
Total Invoice Amount 332.22
Check/Credit Memo No: Payment/Credit Applied
`332.22'
Safety Systems �O
4113 Turner Road
Richmond, IN 47374 Invoice Number: 12111211
Invoice Date: Nov 12, 2012
Page: 1
Voice: 765-935-3566 Duplicate
Fax: 765-935-9713
!"BiII TO.-.,',, Ship'to: „
Carmel Fire Dept.
2 Civic Square
Carmel, IN 46032
CustomerID '` Customer PO Payment Terms
--`carmel-f.d----- __ -Net 30 Days — -- –
Sales-Rep:ID Sh pping'Meth4 Ship Date' Due Date.
UPS Ground 12/12/12
Quantity;.' `. Item; Description Uni.CPrice" ''.Amount.
2.00 UT-101 Lap Top Mount-Havis 202.81 405.62
1.00 shipping shipping 11.03 11.03
Subtotal 416.65
Sales Tax
Total Invoice Amount 416.65
Check/Credit Memo No: Payment/Credit Applied
TOM,
416.65'j
Drescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
4n invoice or bill to be properly itemized must show: kind of service,where performed, dates service rendered, by
rohom, 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))
12111212 $332.22
1211211 $416.65
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
Safety Systems
IN SUM OF $
4113 Turner Road
Richmond, IN 47374
$748.87
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. I ACCT#!TITLE AMOUNT Board Members
1120 12111212 j 42-370.00 $332.22 1 hereby certify that the attached invoice(s), or
1120 1211211 42-370.00 $416.65 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 b C 2012
!" <
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund