HomeMy WebLinkAbout230197 03/12/14 ,CSA
%� - CITY OF CARMEL, INDIANA VENDOR: 361470
® i' ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $•-...549.15'
CARMEL, INDIANA 46032 305 LAKE ROAD CHECK NUMBER: 230197
9.y _oN, .= MEDINA OH 44256 CHECK DATE: 03/12114
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
900 4359005 31508 223244 549.15 CHILD SEATS
MERCURY Invoice
DISTRIBUTING
305 Lake Road, Medina,OH 44256
Ph:330.723.4739 Fax:330.721.6799 Invoice Number: 0000223244
REMITTANCE ADDRESS:
WESTERN RESERVE DISTRIBUTING, INC. Invoice Date: 2/21/2014
dba MERCURY DISTRIBUTING or CHILD SOURCE
305 LAKE RD Invoice Due Date: 3/23/2014
MEDINA,01-144256
Customer: CARMPD
Taxi ID 982-0563593
Sales Order 000012370
� 1:
CARMEL POLICE DEPARTMENT,CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 OAKRIDGE ROAD
CARMEL, IN 46032-2584 USA Cannel, IN 46032 USA
31508 UPS ORIGIN Net 30 Days
Sli [Jaa I' i
d: ..
3702098 TITAN 5 CARSEAT 50#2PK 4 $ 57.7500 $ 231.00
IC068FSM ON BOARD35 INFANT CAR SEAT W/BASE 2 $ 77.4000 $ 154.80
93-209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 2 $ 47.2000 $ 94.40
-- - -- --------- ---- LAST ITEM -
I
i
Tracking Numbers.- 1 ZA7T6670397359046, 1 ZA7T6670397853083, 1 ZA7T6670398397664, 1 ZA7T6670399956272, 1 ZA7T66
Subtotal 480.20
Freight 68.95
Sales Tax 0.00
Discount 0.00
E E154'Aft ON
Payment/CreditAmount 0.00
01
��wa. -�.B.alanee;� 549.15
C0 INDIANA RETAIL TAX EXEMPT PAGE
i ®d Qarmel CERTIFICATE NO.003120155 002 0� PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
2019M`14
Child Gource Ciarm®i Police Department
VENDOR atom Rosmo Distributing, Inc. SHIP 3 Civic Squm
TO
M5 Lake Rd Carmel, IN 48M2
Medina, ON 44258 (397)579
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 00-M.05
9 Each shipping charges $88.95 $88.95
2 Each High Back Booster Front Adj 93-209FSM $47.20 $94.40
2 Each On Board30 Infant Car Sem IrF � $77.40 $154.80
4 Each Adan 5 Carseat $57.75 $231.00
Sub`dotal: $549.15
ak
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Send Invoice To:
Camel Pollco Department
Attn: Pat Young
3 Civic squ@m
Cannel, IN 4832- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Carmel Police Dept. ,� I. PAYMENT W9.15
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE�PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFYiTHAT THERE IS AN UNOBLIGATED BALANCE IN
•SHIP REPAID.
THIS APPROPIR A i ON SUFFICIENT O PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY /
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL 1 J r
SHIPPING LABELS. / hlef of Pollco
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE ft
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. v
qq CLERK-TREASURER
DOCUMENT CONTROL NO. 3 b 5 0 8 A.P.V. COPY-SIGN AND RETURN TO CLERIC'S OFFICE
VOUCHER NO. WARRANT NO.,_�_
ALLOWED 20
_ .. IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# I 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
20 -
.......... ...... _...___..
Signature
...............___......__ ..................._......_............__......................__............---.............................._..........._.........................._............_....
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
Child Source
Western Reserve Distributing, Inc. IN SUM OF $
305 Lake Rd
Medina, OH 44256
$549.15
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Grant Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
31508 I 0000223244 I -590.05 I $549.15 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
Tuesday, March 04, 2014
Chief of Police
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))
03/23/14 0000223244 car seats $549.15
I 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