226702 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 357702 Page 1 of 1
�f. ONE CIVIC SQUARE HYDRAULIC COMPONENT SPECIALISTI;HECK AMOUNT: $1,567.40
1 f� CARMEL, INDIANA 46032 13595 LANDSER PLACE
CARMEL IN 46033 CHECK NUMBER: 226702
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 8176 1, 567 . 40 REPAIR PARTS
Hydraulic Components Specialists, LLC Invoice
13595 Landser Place
Carmel, IN 46033 Date Invoice#
11/19/2013 8176
Bill To Ship To
Carmel Street Department Carmel Street Department
3400 W. 131st Street 3400 W. 131st Street
Cannel,IN 46074 Westfield,IN 46074
P.O. No. Terms Account# Job Description
I-
Jeff-cooper - - Net 30 250167 John Deere j44G
Qty Item Description Unit Price Amount
Reseal/Repair John Deere 544G Lift Cylinder X 2
2 Seal Kit 324.40 648.80
2 Enviromental Fee 20.00 40.00
2 Labor 425.00 850.00
Freight 28.60 28.60
Sales Tax (7.0%) $0.00
Total $1,567.40
Shop:.5438 Barker Lane Indianapolis, Indiana 46236 Payments/Credits $0.00
Phone (317)X895-6916,
Fax (317) 895-6927 Balance Due
$1,56 7.40
Conditional limited warranty as determined by
Hydraulics Component Specialists LLC
VOUCHER NO. WARRANT NO.
ALLOWED 20
Hydraulic Components Specialists, LLC
IN SUM OF $
13595 Landser Place
Carmel, IN 46033
$1,567.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE I AMOUNT Board Members
2201 I 8176 I 42-370.00 j $1,567.40 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
Tues a Nove' ber 26, 2013
4reee �nrr ist d,Q r
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))
11/19/13 8176 $1,567.40
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
120
Clerk-Treasurer