226803 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 359261 Page 1 of 1
` ONE CIVIC SQUARE SAFETY SYSTEMS
CARMEL, INDIANA 46032 4113 TURNER ROAD CHECK AMOUNT: $140.27
RICHMOND IN 47374
CHECK NUMBER: 226803
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4237000 13111914 140 . 27 REPAIR PARTS
Safety Systems INVOICE
4113 Turner Road
Richmond, IN 47374 Invoice Number: 13111914
Invoice Date: Nov 18, 2013
Page: 1
Voice: 765-935-3566 Duplicate
Fax: 765-935-9713
'Bill To „4.. Ship'to
Carmel Fire Dept.
2 Civic Square
Carmel, IN 46032
� �
Customer IDS �. Customer�PO Payment Terms
as;..,,.,�,.,s', �. x -t „a+-Z'�-.., .$e$�i...eL �.,:.�i 3�' _a,Eb..: o.�x�ai�. .kn .'4c kt"$•�',+tt+�r,+a
-- - carmel-f.d. Net 30 Days --
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t,N Sales Rep ID ,. '�.. Shi png;Methocl Datev .t Di e Dater -
UPS Ground 12/18/13
QuantrE Ifem , escnption � sUn�t Price Amount
•'.,�, �3" ..='"4 _`'? ..c<LS }a�n,3h+5s'4a-�aI50a a�..-r-' �. a .. ..:,a .. ri'Y�. .f,.�aaxa .k e'..,.e „�_ u?'(�$SW�...
1.00 C-HDM-108 70.09 70.09
1.00 C-HDM-420 59.25 59.25
1.00 shipping shipping 10.93 10.93
Subtotal 140.27
Sales Tax
Total Invoice Amount 140.27
Check/Credit Memo No: Payment/Credit Applied
VOUCHER NO. WARRANT NO.
ALLOWED 20
Safety Systems
IN SUM OF $
4113 Turner Road
Richmond, IN 47374
$140.27
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE I AMOUNT Board Members
1120 I 13111914 I 42-370.00 I $140.27 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
NIC °2 2011
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))
13111914 $140.27
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