219870 05/07/2013 a CITY OF CARMEL, INDIANA VENDOR: 355226 Page 1 of 1
` ONE CIVIC SQUARE PUBLIC SAFETY CENTER, INC
CHECK AMOUNT: $517.95
CARMEL, INDIANA 46032 8248 W DOE AVENUE
<.oe,do VISALIA CA 93291 CHECK NUMBER: 219870
CHECK DATE: 517/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
102 4239011 5409538 260 .44 SPECIAL DEPT SUPPLIES
102 4239011 5409556 257 . 51 SPECIAL DEPT SUPPLIES
INVOICE
�gg,,,,'"" INVOICE
r ublic ,f iy Cwter 5409538
8248 West Doe Ave.
Visalia, CA 93291 Invoice Date Page
AR (559)651-0919 x122. 04/12/2013 1 1 of 1
Orders (866)646-4434 ORDER NUMBER
www.publicsafetycenter.com 1248604
Bill To: Ship To:
Carmel FD Carmel FD
ATTN:ACCOUNTS PAYABLE ATTN: MARK HULETT
2 CIVIC SQ. 2 CIVIC SQ,
Carmel,IN 46032 Carmel,IN 46032
US US
Customer ID: 152610
PO Number Terms Description Net Due Date Disc Due Date Discount Amount
Net 30 5/12/2013 5/12/2013 0.00
9sh ate Pick Ticket No Job No Freight Primary Salesrep Name Taker
13 3259324 0064000000QXriIAA Prepay and Add Harriett Keys Automated Service
�n /tem ID Item Deseri l ion UOM Unit Extended apped Description Size Price Price
Delivery Instructions: FREIGHT OUT
Carrier: UPS-Ground Tracking#: 1Z1759310345466238
3 3 MIIEMZSI 1100Z Nonnal Saline Flush Syringe, IOmL BX1.0000 79.0000 237.00
100 EA/BX
Total Lines: I SUB-TOTAL: 237.00
Total Freight In:0.00 Total Freight Out:23.44 TOTAL FREIGHT. 23.44
TAX: 0.00
AMOUNT DUE: 260.44
(IS. Dollars
ORIGINAL
INVOICE
INVOICE
PaubfieSafayCen#'e'P' 5409556
8248 West Doe Ave.
Visalia, CA 93291 Invoice Date Page
AR (559)651-0919 x122. 04/12/2013 1 of 20
Orders(866)646-4434 ORDER NUMBER
www,publicsaTe)icenter.com
1248603
Bill To: Ship To:
Cannel FD Cannel 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 Terms Decc•riptiott Net Due Date Disc Due Dade Discount Antou»t
Net 30 5/12/2013 5/12/2013 0.00
Order Date Pick Ticket No Job A'o Freight Primary Salesrep Alame Taker
04/12/2013 3259327 0064000000QXrhDAA r Prepay and Add Harriett Keys Automated Service
Oh' Q!t' /teat/D Item Description Will Unit Extended
Ordered Shipped P Unit Size Price Price
Delivery Iitstructiotts: FREIGHT OUT
Carrier: UPS-Ground Tracking#:IZ82X74X0358406599
I I GRP51926 Nonwoven,MegaMover 1500 C90.0000 229.9000 229.90
"Portable Transport Unit.40""x 80""-White, (10/CS)"
To/al Lines: I SUB-TOTAL: 229.90
Toted Freight In:0.00 Total Freight Out:27.61 TOTAL FREIGHT: 27.61
TAX: 0.00
AMOUNT DUE: 257.51
U.S.Dollars
ORIGINAL
7rescribed 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
rdhom, 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))
5409538 $260.44
5409556 $257.51
I 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
Public Safety Center
IN SUM OF $
8248 W. Doe Avenue
Visalia, CA 93291
$517.95
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 5409538 102-390.11 $260.44 1 hereby certify that the attached invoice(s), or
1120 5409556 102-390.11 $257.51 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
MAY 6 2013
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund