224097 09/10/2013 voided CITY OF CARMEL INDIANA VENDOR: 252310 Page 1 of 1
ONE CIVIC SQUARE PRO AIR INC
CARMEL, INDIANA 46032 1126 AIR DRIVE CHECK AMOUNT: $16,700.00
BLOOMINGTON IN 47404 CHECK NUMBER: 224097
CHECK DATE: 9/10/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4351000 24468 3021788 16, 700 . 00 INSTALL FILL STATION
P R 0 A I R INVOICE
3021788 Date of 08/26/2013 ast.
REMIT TO:Koorsen Fire&Security No.: Work: O#.
2719 N Arlington Avenue
Indianapolis,IN 46218-3322 Invoice Date: 08/26/2013 SO#: 2641332 Date 09/20/2013
1-888-KOORSEN Include invoice#on check. Due:
Cust ID 21CAR0002 JOB# SERVICE21 / 6
Sold To: Location:
CARMEL FIRE DEPT CARMEL FIRE DEPT - RESCUE 45
2 CIVIC SQ 10701 N COLLEGE AVE
CARMEL, IN 46032 INDIANAPOLIS, IN 46280
21-HOUSE / 21-371550 / STOCK21
M�
(1) TWO POSITION FILL STATION AND (1) SIERRA ELECTRIC
BOOSTER ---
1.00 TWO POSITION FILL STATION 6400.00 6400.00
1.00 SIERRA ELECTRIC BOOSTER 9500.00 9500.00
8.00 LABOR 100.00 800.00
TOTAL SALES/SERVICES XMP# 0031201550-020 16700.00
TOTAL 16700.00
Pay online @ www.koorsen.com. To pay by credit card,please phone or return to us:
Circle:VISA MC AMEX Card Number — —
————————— ———— ————
Name on Card Expiration Date—/-
Total Sales Taxable Sales Tax Amount Shipping Charge Invoice Total
16,700.00 0.00 0.00 16700.00
VOUCHER NO. WARRANT NO.
ALLOWED 20
Pro-Air
IN SUM OF $
1126 Air Drive
Bloomington, IN 47404
$16,700.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
24468 I 3021788 I 43-510.00 I $16,700.00 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 qEP 71 20M
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))
3021788 $16,700.00
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