224467 09/25/2013 CITY OF CARMEL, INDIANA VENDOR: 079150 Page 1 of 1
ONE CIVIC SQUARE DONLEY SAFETY CHECK AMOUNT: $93.50
CARMEL, INDIANA 46032 5546 ELMWOOD AVE
94ON �+ INDIANAPOLIS IN 46203 CHECK NUMBER: 224467
CHECK DATE: 9/25/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 40377 93 . 50 REPAIR PARTS
L ONLEY IMFM INVOICE
Please visit us on the web at www.donleysafety.com
Phone 317-786-2268 Date Invoice#
5546 Elmwood Ct- Fax 317-786-2532
Indianapolis, IN 46203 9/9/2013 40377
Bill To Ship To
CARMEL FIRE DEPARTMENT CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE ATTN:
CARMEL,IN 46032 2 CIVIC SQUARE
CARMEL,IN.46032
I
P.O. Number Terms Salesperson Ship Via F.O.B. S.O.#
VERBAL NET 30 FS WILL CALL
Ordered Shipped B/O Item Number Description Unit Price UOM Ext. Price
2 2 0 02840048 DOOR STOP/HOLD-OPEN 46.75 SET 93.50
Sales Tax (7.0%) $0.00
PRICE DISCREPANCIES, RETURN REQUESTS OR Total
SHIPMENT ERRORS MUST BE REPORTED WITHIN 30 $93.50
DAYS TO RECEIVE CREDIT.
Questions about this invoice? Please call 317-786-2268.
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))
40377 $93.50
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
Donley Safety
IN SUM OF $
5546 Elmwood Court
Indianapolis, IN 46203
$93.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I 40377 I 42-370.00 I $93.50 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
SEP 2 3 2013
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund