FORM FIN1510-01 For Accounts Payable Use Only Vendor Number  GEORGI  CHECK REQUEST FORM  6630  Use this formt to arranget for payment toi individuals or businesses when al Purchase Order or P-card is not required.  This form must be submitted in typed format only.  Vendor Information Date heninch Sesvza lfpaymenti is to a Vendor, isaV W-9on filei in the Purchasing Office? IFNo, a completed W-91 MUSTbe attached. Email Meagan Porchi in our Purchasing Division. neaxan.perch@rock.lalecountypasow EXPENSE/ACCOUNT DETAILS Date of Service or Invoice 8/29/2024  Vendor or Employee Name Williams Fire Apparatus Mailing Address  9/20/2024  Email Address  Description (forindividuals, Services, Expense Reimbursements) LADDER: 1 was down and out ofs service. Emergency repairs to Remove &F Replace Main Power & Ground) Wirei in Cable Track. Time was of the essence ing getting Ladder Truck back in Serv Total Labor $11,919.70, Parts+Shop! Supp $9,978.61 nvoice# 25037 Attached forf full details ofs services rendel  General Ledger Account Fund Function Account Dept.  Amount $21,898.41  100  4900 531100. 42 522200  Total Check Amount $21,898.41  DESCRIBE FULLY THE NATURE OF THE PAYMENT  Ensrgenegepnta Laddia 1  SGNATURES/APPROVAS Director of Finance Purchasing  Dept. Designge/ Datg S79ff Accountaryk pate  Date Date  Y04  enahu 22 9142H  alno 4b4by Enclose attachmentsi ifrequiredi in letters size Avallable at theF Finance Office Front Desk after Will bep placedi in mailbox after 2:00p p.me every  CHECK'H HANDLING INSTRUCTIONS 6.Pick Up-Approval! by Finance Director 2:00 pme everyFriday  S.Mail envelope)  7. Sendl Inter- Department Mail  Please sendt thist form with attachments to the Department of Finance. Each check request received Monday-Fridayl willl be  processed the following Friday.  hn  2024-541    Page:1of3 25037 8/29/2024  Williams Fire Apparatus 778 Idaho Road Ashland, AL 36251 (800) 239-7900  Invoice: Date:  customerservce@wiamstrenc.com  WILLIAMS FIASA APPARATUB  BiITo  Ship To Department  Remit Payment To Apparatus  Rockdale County Fire Department 14961 Rockbridge Rd. Conyers, GA3 30012  Rockdale County Fire Williams Fire 1496 Rockbridge Rd. 778 Idaho Road Conyers, GA: 30012 Ashland, AL 36251  Service Order Terms Due Date  Authorizer Customer PO  Service Writer Spangenberg, Josh  Unit# L1 ROCKDALE COI FDHS 5437 Rate Amount $90.00 $189.00  6206 Item Bring unit to shop Labor  Net 30 9/28/2024  Description Bring unit to shop  Quantity 2,10000  Shipping, 1496 Rockbridgel Rd., Conyers, GA: 30012, US  Complaint: Remove and replace main power and ground wirei in the cable track.  Cause: Customer request (Inspection) Labor  Correction:  45.33000 $134,00 $6,074.22  Aerial Aerial Structure / -Set thet truck up and extended the. Aerial -We unt bolted the cable track on bothe ends -Cutz zipt ties loose and cut one end of the power cable -Tied new wire tot the old and pulled in threw the cable track -We disconnected the old wire and hooked new wire back up -Wez zipt tied everything back up andt tested Aerial -Folded Aerial back up -Remove extension and retraction cables from all sections ofl ladder -Cutr new cables to length -Installed eyelet on end ofr new cables to specs Reinstalled new cables -Adjusted cables tos sutphen specs -Ran aerial tos seat cables -Adjusted cables again -Lube aerial -Lube waterway and cables Cable Eye for cables 3/8 10065563 Shipping- Shipping (Parts) FUEL NSVCC-FUEL  Parts Parts Parts Parts Parts  Cable Standard 3/8"X30'6X37 IWRC WICISTUDBOLT-10041026  8.00000 $376.92 $3,015.36 8.00000 $100.7732 $806.19 1.00000 $235.32 $235.32 1.00000 $376.92 $376.92  1.00000  $78.81  $78.81  Cable Standard 3/8"X30'6X37 WRC WIC1STUDBOLT-10041026    Page:2of3 Rate Amount $12.45 $12.45 $95.96 $383.84 $95.96 $21.00 $95.96 $10.48 $15.88 $35.47  item Parts Parts Parts Parts Parts Parts Parts Parts Parts  Description  Quantity 1.00000 4.00000 1.00000 2.00000 1.00000 2.00000 2.00000 1.00000  Strain Relief Grip str 3/4" hub .62-.75 cable aluminum 10042738 Cable Standard 3/8"X30'6X37 IWRC WIC1STUDBOLT- 10041026 3/8 OVAL EYE SOCKETS W/MB737 FOR SP CABLE CABLE ENDS- 3/8 OVAL EYE: SOCKETS W/MB737 FOR SP CABLE CABLE ENDS- 3/8 OVAL EYE SOCKETS W/MB737 FOR SP CABLE CABLE ENDS- SWITCH DOOR CAB/ AND COMPARTMENT 91823 10033320 12"20LB GAS SHOCK (6554UD)- 10062472 Haldex Air Brake Compressor Governor MCP18530  3.00000 $376.92 $1,130.76  10065563 10065563 PRO-ONE GREASE-4 46014 10065563  $95.96 $42.00 $95.96 $20,96 $31.76 $35.47  Complaint: Cable Trough Cause: Customer request (Inspection) Labor  Correction: off Stretched out ladder -Unbolted cable track -Tied track up out oft the way -Unbolted cable troughs -Slid troughs out of ladder -Began removing Polly and cleaning glue Removed poly from the sides of ali troughs -Scraped all remaining glue and adhesive from the sides andi insides of troughs -Cut new poly to length -Put 3ma adhesive promoter on the troughs -Stuck new poly down and rolled ont tor not have any bubbles and get good adhesion -Clamped boards ont troughs to make: surei it adheres -CHANGED LIGHT ANDI FRONT DOORI LATCH -TESTI DROVE TRUCK -ADJUSTED. AIR GOVERNOR -REPLACED AIR DRYER FUEL NSV CC- FUEL NAF 25 NPF002 FUEL NSVCC-FUEL NFPA PUMP TEST-NFPA PUMP TEST  40.87000 $134.00 $5,476.58  Body and Cab/ /General/ /-Poly on the sides oft the cable troughs was coming  REMOVED AND REPLACED 20 COMPARTMENT DOOR SWITCHES 941 PRIMER 80Z PAIL (aerial trough) MMM23926  Parts Parts Parts Parts Parts Parts Parts  1.00000 1.00000 $125.00 $125.00 100.00000 1.00000 $20.6756 1.00000 $950.00 $950.00 1.00000 1.00000 $325.00 $325.00  $23.48  $23.48  UHMWI Bik PSA UV6") x 1/16" HPA-1905. Adhesive (ft)- 10064812 NFPA AERIAL PERFORMANCE TEST NFPA 3RD PARTY TEST  $7.44 $744.00  $20.68 $0.00  $0.00    Page: 3of3 Rate Amount $7.44 $744.00 $5.64 $564.00 $90,00 $180.00  Item Parts Parts Return unit Labor  Description  Quantity 100.00000 100.00000 2.00000  UHMW Bik PSA UV6"x1 1/16" HPA-1905 Adhesive (#)-10064812 UHMWI blk psa uv 4.5"x1 1/16" AV1126. ADHESIVE. 10064811  Return unit  Shipping, 1496 Rockbridge Rd., Conyers, GA: 30012, US  Unit: ROCKDALE CO FD HS 5437 (Ladder 1) VIN: 1S9A3MNE4E5003136  Shop Supplies $120.69 Pre-Charge Subtotal $21,898.41 Local (0%of$0.00) Total $21,898.41 Payments & Credits Balance Due $21,898.41  SUTPHEN SP90 Aerial: 0 Hours Chassis: 12,345 Miles Engine: 0 Hours Fire Pump: 0 Hours  $0.00 $0.00  Any warranties on the parts and accessories sold hereby are made by the manufacturer. You understand and agree that we make no warranties of any kind unless expressed in writing. You hereby authorize us to perform the repair work herein set forth and to purchase the necessary material and parts to perform such repair work. You agree that we are not responsible for loss or damage to your vehicle or articles lefti iny your vehicle in case off fire, theft, or any other cause beyond our control or for any delays caused by unavailability of parts or delays inp part shipments by the supplier or transporter. in addition, you agree that we are not responsible for damages toy your vehicle from freezing due to lack of antifreeze. You hereby grant our employees permission to operate your vehicle on streets, highways, or elsewhere for the purpose of testing and/or inspection. You acknowledge and agree that an express mechanic's lien on your vehicle is granted to secure payment of this invoice fori the  repair work detailed in this invoice.  Customer Signature:_ Printed Name:  Date:_