218885 04/09/2013 CITY OF CARMEL, INDIANA VENDOR: 131135 Page 1 of 1
ONE CIVIC SQUARE HOOSIER FIRE EQUIPMENT INC
s CHECK AMOUNT: $2,221.00
CARMEL, INDIANA 46032 4009 MONTDALE PARK DRIVE
VALPARAISOIN 46383 CHECK NUMBER: 218885
CHECK DATE: 419/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 83397 2 , 221 . 00 AUTO REPAIR & MAINTEN
****** INVOICE ****** PAGE: 1
Hoosier Fire Equipment, Inc. INVOICE NUMBER: 0083397-IN
4009 Montdale Park Drive INVOICE DATE: 03/29/13
Valparaiso, Indiana 46383
ORDER NUMBER:
ORDER DATE:
(219) 462-1707 SALESPERSON House
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
OUR DELIVERY Net 10
--------------------------------------------------------------------------------
ITEM NO. UNIT ORDERED SHIPPED BACK ORD PRICE AMOUNT
--------------------------------------------------------------------------------
/SERVICE EACH 1 . 00 1 . 00 0 . 00 2, 221 . 00 2, 221 . 00
REPAIRS ON CUSTOMER' S 2010 SEAGRAVE TDA SERIAL
#76397, LADDER #41 - AS PER ATTACHED
TAXABLE . 00
NON-TAXABLE 2, 221 . 00
NET INVOICE: 2, 221 . 00
SALES TAX: . 00
FREIGHT : . 00
INVOICE TOTAL: 2, 221 . 00
❑ HOOSIER FIRE EQUIPMENT, INC. ❑ HOOSIER FIRE EQUIPMENT, INC.
QTY. PART NO. AND/CIR,DESCRIPTI IN PRICE 4009 Montdale Park Drive 3863 North Commercial Parkway
1 Return Hydraulic Filter $77.00 Valparaiso, IN 46383 Greenfield, IN 46140
1 Pressure Hydraulic Filter $134.00 Phone: 219-462-1707 Phone: 317-891-8375
1 DPF Instruction Label $15.00 Toll Free: 800-552-2691 Toll Free: 888-436-6075
2 Shipping/Freight $22.00 REPAIR ORDER
NAME: Carmel Fire Department RECEIVED: 2/26/2013 DATE: 3/15/2013
CUSTOMER
1 3500 PSI Cab Lift Hydraulic Pump No Charge ADDRESS: Two Civic Square PROMISED: ORDER#
3 Fluid for Hydraulic Pump(DEX III, quarts) No Charge CITY: Carmel, IN 46032 TERMS: MECHANIC: MS
PHONE:
1 Auto Pump HP& Mounting Plate $802.00 MAKE: MODEL: YR. SERIAL NO. UNIT MILEAGE AIR
1 Shipping/Freight $16.00 Seagrave TDA 2010 #76397 Ladder 41 17,612 6060
LABOR HOURS REPAIR ORDER INSTRUCTIONS CHARGE '
Performed Annual Ladder Preventative Maintenance Service. $775.00
Repaired rung alignment light, see notes.
Installed updated cab lift pump&replaced electrical termials. No Charge
Test operated-okay.
Installed DPF instruction label. No Charge
Installed new Kussmaul heavy duty compressor&relocated charger unit. $380.00
LS3 compartment out of alignment. Removed & replaced fasteners and No Charge
realign compartment to frame.
ADDITIONAL PARTS SEE LIST ON BACK
PARTS TOTAL $1,066.00
SUBLET WORK PRICE
I hereby authorize the above repair work to be done w/the necessary material,and hereby grant you and/or your employees
permission to operate the car or truck herein described on streets,highways or elsewhere for the purpose of testing
and/or Inspection. An express mechanic's lien is hereby acknowledged on above car or truck to secure the amt.of repairs thereto.
X TOTAL LABOR: $1,155,00
TOTAL PARTS: $1;066.00.
NOT RESPONSIBLE
FOR LOSS OR MILES TRAVEL RATE PRICE SUBLET WORK:
DAMAGE TO CARS OR
ARTICLES LEFT IN TRAVEL EXP..
CARS IN CASE OF ` '
FIRE,THEFT OR ANY TAX:
OTHER CAUSE
BEYOND OUR
SUBLET WORK TOTAL` It CONTROL. TOTAL TRAVEL EXPENSES: TOTAL $2,221:00
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))
83397 L41 $2,221.00
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
$2,221.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I 83397 I 43-510.00 I $2,221.00 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
APR ® 9 2013
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund