216425 01/15/2013 CITY OF CARMEL, INDIANA VENDOR: 131135 Page 1 of 1
ONE CIVIC SQUARE HOOSIER FIRE EQUIPMENT INC
r CARMEL, INDIANA 46032 4009 MONTDALE PARK DRIVE CHECK AMOUNT: $728.80
VALPARAISO IN 46383 CHECK NUMBER: 216425
CHECK DATE: 1/15/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4467099 24421 82566 728 . 80 STRAINER - E46
****** INVOICE ****** PAGE: 1
Hoosier Fire Equipment, Inc. INVOICE NUMBER: 0082566-IN
4009 Montdale Park Drive INVOICE DATE : 01/07/13
Valparaiso, Indiana 46383
ORDER NUMBER: 0111866
ORDER DATE: 01/02/13
(219) 462-1707 SALESPERSON R. W. Pressel
CUSTOMER NO: CARM01
SOLD TO: SHIP TO:
Carmel Fire Department Carmel Fire Department
2 Civic Square 2 Civic Square
Carmel IN 46032-7543 Carmel IN 46032-7543
CONFIRM TO:
CUSTOMER P.O. SHIP VIA F.O. B TERMS
E46 UNITED PARCEL DESTINATION Net 10
--------------------------------------------------------------------------------
ITEM NO. UNIT ORDERED SHIPPED BACK ORD PRICE AMOUNT
--------------------------------------------------------------------------------
/SORDER EACH 1 . 00 1 . 00 0 . 00 728 . 80 728 . 80
#A03HNX-JET, TASK FORCE TIPS 6" NST LOW LEVEL
STRAINER WITH 1-1/2" NST JET SIPHON
TAXABLE . 00
NON-TAXABLE 728 . 80
NET INVOICE: 728 . 80
SALES TAX: . 00
FREIGHT: . 00
INVOICE TOTAL: 728 . 80
Drescribed by State Board of Accounts City Form No.201 (Rev.1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
M 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))
82566 Task Force Tips Strainer- E46 $728.80
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
Hoosier Fire Equipment
IN SUM OF $
4009 Montdale Park Drive
Valparaiso, IN 46383
$728.80
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
24421 I 82566 1 102-670.99 I $728.80 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
JAN 14 2013
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund