223549 08/27/2013 CITY OF CARMEL INDIANA VENDOR: 178450 Page 1 of 1
` ONE CIVIC SQUARE KUSSMAUL ELECTRONICS CO IN
i CARMEL, INDIANA 46032 170 CHERRY AVE CHECK AMOUNT: $403.80
WEST SAYVILLE NY 11796-1221 CHECK NUMBER: 223549
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 13881 403 . 80 AUTO REPAIR & MAINTEN
MWEIKUSSMAUL Invoice No 0000013881
Remit To:
Phone:800-346-0857 170 cherry Ave. Sales Order No 004060-00
Fax:631-567-5826 West Sayville,
E-Mail:sales @kussmaul.com NY 11796
Packing List No 004652
Bill to : CAR033 Ship to :
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE 2 CIVIC SQUARE
CARMEL IN 46032 CARMEL IN 46032
United States United States
Phone(317)571-2600
Customer PO Number Invoice Date Terms FOB Ship Via Coordinator
VERBAL JASON 08/0812013 NET 30 DAYS WEST SAYVILLE,NY FED-EX GROUND RESIDENTIAL CST
Item Part/Description Serial Number Quantity Unit Price Extended Price
000010 091-55-20-120-YW 1.00 279.00000 279.00
SUPER AUTO EJECT 120 VOLT AC 20 AMP
091-55-20-120 S 2 013 4 9 7 6 1
SUPER AUTO EJECT 120 VOLT AC 20 AMP
091-55YW
WEATHERPROOF COVER,YELLOW
000040 REPAIR OF 091-20WP-120 1.00 110.00000 110.00
S/N:W2702958 REPAIR#:WP402
000050 SHIPPING 1.00 14.80000 14.80
Shipping/Freight Charge, Ref Shipper No 004652
Shipped on 08/0812013
Thank you for your order. Total Item Price 389.00
Tracking# 023887570004314 Shipping 14.80
Sales Tax 0.00
Total Inv Price US$403.80
Please pay balance due by Saturday September 7 2013
CUSTOMER COPY
Page 1 Authorized Signature
VOUCHER NO. WARRANT NO.
ALLOWED 20
Kussmaul Electronics
IN SUM OF $
170 Cherry Avenue
West Sayville, NY 11796
$403.80
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#lrITLE I AMOUNT Board Members
1120 I 13881 I 43-510.00 I $403.80 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 AIJG 2 6 2019
9N'1117L-y'OV
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))
13881 $403.80
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