225111 10/08/2013 CITY OF CARMEL, INDIANA VENDOR: 359187 Page 1 of 1
ONE CIVIC SQUARE TENNANT SALES&SERVICE CO
CARMEL, INDIANA 46032 P o Box 71414
CHECK AMOUNT: $2,569.47
CHICAGO IL 60694-1414 CHECK NUMBER: 225111
CHECK DATE: 10/8/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 911904367 2, 569 . 47 REPAIR PARTS
I
Remit Payment To Tel 1-800-553-8033
069008351600 Tennant Sales and Service Company
Fax 1-763-513-2142
PO Box 71414
JEN NAMI MAIP CHICAGO IL 60694-1414 Invoice
DOli�i
USA I
Ship-To Invoice Number 9.11904367
CITY CARMEL CITY CARMEL Invoice Amount 2569.47
STREET T DEPT STREET T ,
DEPT 2,5691
.47
W 131ST ST 3400 W 131ST ST Currency US Dollars
WESTFIELD IN 46074-8267 WESTFIELD IN 46074-8267 Document Date 09/24/2013
Payment Terms
Net 30 Days
Bill-To Final due date 10/24/2013
CITY OF CARMEL
STREET DEPT
3400 W 131ST ST Customer Number 5112774
WESTFIELD IN 46074-8267 PO Number
SIGNED WORK ORDER
Contact JEFF STEWART
317-417-5053
Date of Service --- 0912412013
Serial Number 528-31990
Service Notification 303774629
Service-Order 14884740
Unit Extended Tax
Qty Unit Material Description Price Value
Notes
ordered parts and sent to customer
1 H TRIPMM TRIP, NO CHARGE, MULT MACH N
Net Value 0.00 0.00
0.50 H LABORREGULAR LABOR, REG RATE N
Price 110.00 55.00
Net Value 110.00 55.00
4 PC 87579 LATCH, TENS N
Price 18.70 74.80
Net Value 18.70 74.80
1 PC 86723 BLADE ASSY, SAGE, SIDE [530E] N
Price 50.00 50.00
Net Value 50.00 50.00
2 PC 69725 FRAME WLDT, SAGE, SIDE, RH [527] N
Price 94.00 188.00
Net Value 94.00 188.00
i
Please include invoice number with payment. All modifying agreements must be in writing and signed by both parties. The items specified have been produced incompliance with the
Fair Labor Act of 1938, as amended. Customer must obtain authorization before returning goods by contacting Tennant at telephone numbers shown above. Selected items and
conditions appear hereon. All orders are subject to additional terms and conditions which are available on Tennant's website at www.tennantco.com/legal/terms_conditions or available in
printed form upon request.
Page 1 of6
069008352600 Remit Payment To Tel 1-800-553-8033
Tennant Sales and Service Company Fax 1-763-513-2142
PO Box 71414
JENNANJCHICAGO IL 60694-1414 Invoice
USA
Ship-To Invoice Number 911904367
CITY OF CARMEL CITY OF CARMEL Invoice Amount -- 2;569.47:,.
STREET DEPT STREET DEPT .-_.t :- ...
3400 W 131ST ST 3400 W 131ST ST Currency US Dollars
WESTFIELD IN 46074-8267 WESTFIELD IN 46074-8267 Document Date 09/24/2013
Payment Terms
- Net 30 Days
Bill-To. Final due date 10/24/2013
CITY OF CARMEL
STREET DEPT
3400 W 131ST ST Customer Number 5112774:
WESTFIELD IN 46074-8267 PO Number
SIGNED WORK ORDER
Contact JEFF STEWART
317-417-5053
Date:of Service:::;.:::::;:>> ..*.::09/24/2013_....
...:... ,>:.::.:...:...
Serial Number 528-31990
Service Notification 303774629
Service Order 14884740
. .... ........ .. _... _ .. _..._ .. ..._.. .- .. _. -..........
Unit::**'.** xten a .: az::.:
Qt y> ;:Unit Material Description >.. Price Value"
2 PC 69724 FRAME WLDT, SAGE, SIDE, LH [5271 N
Price 94.00 188.00
Net Value 94.00 188.00
2 PC 64320 HOSE ASSY, W/1 CUFF, 3.OD 024L 3.0/ N
Price 34.80 69.60
Net Value 34.80 69.60
2 PC 60006 BLADE, SAGE, 049.01- N
Price 101.00 202.00
Net Value 101.00 202.00
2 PC 60005 BLADE, SAGE, 046.61- N
Price 50.00 100.00
Net Value 50.00 100.00
4 PC 60004 BLADE, SAGE, 27.11- N
Price 25.00 100.00
Net Value 25.00 100.00
2 PC 59826 RETAINER WLDT, BLADE, SAGE, 1.3W 46.31- N
Price 35.90 71.80
Net Value 35.90 71.80
2. PC 59800 RETAINER WLDT, BLADE, SAGE, 1.3W 49.1L N
Price 34.70 69.40
Net Value 34.70 69.40
2 PC 59775 STRIP N
Price 9.50 19.00
Net Value 9.50 19.00
2 PC 59663A RETAINER, SAGE, SIDE [5281 N
Price 28.10 56.20
Net Value 28.10 56.20
4 PC 59639A GUIDE, TIP, SQGE N
Price 8.60 34.40
Page 2 of6
069008353600 Remit Payment To Tel 1-800-553-8033
Tennant Sales and Service Company Fax 1-763-513-2142
PO Box 71414
JENNANJCHICAGO IL 60694-1414 Invoice
USA
Ship-To Invoice Number:: . 91 1904367.
CITY OF CARMEL CITY OF CARMEL Invoice Amount .:2,569:47:::
STREET DEPT STREET DEPT
3400 W 131ST ST 3400 W 131ST ST Currency US Dollars
WESTFIELD IN 46074-8267 WESTFIELD IN 46074-8267 Document Date 09/24/2013
Payment Terms
Net 30 Days
Bill-TO Final due date 10/24/2013
CITY OF CARMEL
STREET DEPT
3400 W 131 ST ST Customer Number 5112774
WESTFIELD IN 46074-8267 PO Number
SIGNED WORK ORDER
Contact JEFF STEWART
317-417-5053
..........
_.....:..._.: -. . .. . .. ..... ...
Date.:of Service 09!24/2013:::::
Serial Number 528-31990
Service Notification 303774629
Service Order 14884740
U ..
nit* .
Extended Tax :._
aty, Unit:.'::':':: Material. Description Price Value
Net Va;ue 8.60 34.40
4 PC 59617 FLAP, CONTAINMENT N
Price 4.80 19.20
Net Value 4.80 19.20
2 PC 59613A BRIDGE WLDT, RH N
Price 37.00 74.00
Net Value 37.00 74.00
2 PC 59612A BRIDGE WLDT, LH N
Price 38.10 76.20
Net Value 38.10 76.20
4 PC 59610A BLADE, SAGE, BACKUP, .12 X 1.5 X 27.1 N
Price 2.00 8.00
Net Value 2.00 8.00
1 PC 30240 BRUSH ASSY, DISK, SCB, 13.OD, PYP N
Price 196.00 196.00
Discounts -19.60 -19.60
Net Value 176.40 176.40
2 PC 19701 BRUSH, SCB, 43L, 24SR, PYP, SPL N
Price 515.00 1,030.00
Discounts -51.50 -103.00
Net Value 463.50 927.00
2 PC 03495 STRIP, NON SLIP, 0.50W 06.OL N
Price 1.10 2.20
Net Value 1.10 2.20
4 PC 03494 STRIP, NON SLIP N
Price 1.20 4.80
Net Value. 1.20 4.80
Subtotal 2,566.00
Page 3 of6
069008354600 Remit Payment To Tel 1-800-553-8033
Tennant Sales and Service Company Fax 1-763-513-2142
PO Box 71414
(i 0 JENNANT CHICAGO IL 60694-1414 Invoice
USA
Ship-To Invoice Number 911904367
CITY OF CARMEL CITY OF CARMEL -
STREET DEPT STREET DEPT Invoice Amount _ - 2,569.47
3400 W 131ST ST 3400 W 131ST ST Currency US Dollars
WESTFIELD IN 46074-8267 WESTFIELD IN 46074-8267 Document Date 09/24/2013
Payment Terms
Net 30 Days
Bill-TO Final due date 10/24/2013
CITY OF CARMEL
STREET DEPT
3400 W 131ST ST Customer Number, 5112774
WESTFIELD IN 46074-8267 PO Number
SIGNED WORK ORDER
Contact JEFF STEWART
317-417-5053
Date of Service.. 09/24/2013,:
Serial Number 528-31990
Service Notification 303774629
Service Order 14884740
Unit Extended Tax
Qty ..Unit Material Description Price Value
ShopSupp&Disposable 3.47
Total 2,569.47
*** Repair Order is Attached
Page 4 of6
069008355600
Repair Order Receipt
Tennant Sales and Service
701 N Lilac Drive
Minneapolis,MN 55427
(800)553-8033
Ship To: Bill To:
CITY OF CARMEL CITY OF CARMEL
STREET DEPT STREET DEPT
3400 W 131 ST ST 3400 W 131 ST ST
WESTRELD,IN 46074-8267 WESTRELD,IN 46074-8267
MODEL 528 SCRUBBER,RIDER(M528/528-31990) Hour Meter:
Ship Date: 12/15/1992
Repair Order#:000303774629 Contact:JEFF STEWART
Date:9242013 Phone:317-417-5053
Cause code: Breakdown PO:SIGNED WORK ORDER
Problem Description:NEED PARTS
Parts
Date Part SLOC Descnption UOM AA Qty
923/2013 03494 1127 STRIP,NON SLIP PC C 2
9232013 03494 1127 STRIP,NON SLIP PC C 2
923/2013 03495 1127 STRIP,NON SLIP,0.50W 06.01- PC C 2
9232013 64320 1127 HOSE ASSY,W/1CUFF,3.OD 024L 3.01 PC C 2
9232013 69724 1127 FRAME WLDT,SAGE,SIDE,LH[527] PC C 2
9232013 69725 1127 FRAME WLDT,SAGE,SIDE,RH 1527] PC C 2
9242013 86723 1127 BLADE ASSY,SAGE,SIDE[530E] PC C 1
9232013 87579 1127 LATCH,TENS PC C 2
9232013 87579 1127 LATCH,TENS PC C 2
9242013 19701 1127 BRUSH,SCB,43L,24SR,PYP,SPL PC C 2
9232013 59610A 1127 BLADE,SQGE,BACKUP, .12 X 1.5 X 27.1 PC C 2
9232013 59610A 1127 BLADE,SQGE,BACKUP, .12 X 1.5 X 27.1 PC C 2
9232013 59612A 1127 BRIDGE WLDT,LH PC C 2
9232013 59613A 1127 BRIDGE WLDT,RH PC C 2
9232013 59617 1127 FLAP,CONTAINMENT PC C 2
9232013 59617 1127 FLAP,CONTAINMENT PC C 2
923/2013 59639A 1127 GUIDE,TIP,SQGE PC C 2
9232013 59639A 1127 GUIDE,TIP,SQGE PC C 2
9232013 59663A 1127 RETAINER,SQGE,SIDE[528] PC C 2
9232013 59775 1127 STRIP PC C 2
9232013 59800 1127 RETAINER WLDT,BLADE,SQGE, 1.3W 49.1L PC C 2
9232013 59826 1127 RETAINER INLDT,BLADE,SQGE,1.3W 46.31- PC C 2
9x1312013 60004 1127 BLADE,SQGE,27.1L — PC- C --2--
W23r2013 60004 1127 BLADE,SQGE,27.11- PC C 2
9232013 60005 1127 BLADE,SQGE,046.61- PC C 2
9232013 60006 1127 BLADE,SQGE,049.01- PC C 2
9242013 30240 1127 BRUSH ASSY,DISK,SCB, I3.OD,PYP PC C 1
Labor/Trips
Date Part Num Svc Rep Description AA Qty/Hrs
9242013 REGLAB 1MC245 Regular Labor C 0.5
9242013 TRIPMM 1MC245 Trip Multi-Machine C 1
Shop Supplies and Tax
Date Description
9242013 Shop Supplies&Disposables
9242013 Tax
i
*** For actual dollars billed please see invoice 91 1904367 *** Page 5 of 6
069008356600
Description of Work Performed
ordered parts and sent to customer
Service Representative-BOBBY BATSON Customer-JEFF
Date:9242013 Date:9242013
I
*** For actual dollars billed please see invoice 91 1904367 *** Page 6 of 6
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))
09/24/13 911904367 $2,569.47
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
Tennant Sales and Service Company
IN SUM OF $
P. O. Box 71414
Chicago, IL 60694-1414
$2,569.47
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
2201 I 911904367 I 42-370.001 $2,569.47 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
Thursi, O 3
st§g' GqfflT&j8IR?er
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund