HomeMy WebLinkAbout231196 04/08/2014 Coq
';� CITY OF CARMEL, INDIANA VENDOR: 361470
i. ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $**.....267.20'
CARMEL, INDIANA 46032 305 LAKE ROAD CHECK NUMBER: 231 196
�;,.a�.�o:= MEDINA OH 44256 CHECK DATE: 04/08/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
900 4359005 0000224857 267.20 CAR SEAT GRANT FOR CP
MERCURY Invoice
DISTRIBUTING
305 Lake Road, Medina,OH 44256
Ph:330.723.4739 Fax: 330.721.6799 Invoice Number: 0000224857
REMITTANCE ADDRESS: Invoice Date: 3/18/2014
WESTERN RESERVE DISTRIBUTING. INC.
dba MERCURY DISTRIBUTING or CHILD SOURCE 4/17/2014
305 LAKE RD Invoice Due Date:
MEDINA,OH 44256 Customer: CARMPD
-^• Tax ID#82-0563593 Sales Order: 0000124341
11
-:.,phi' .To. ;;
CARMEL POLICE DEPARTMENT, CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 OAK RIDGE ROAD
CARMEL,IN 46032-2584 USA Cannel, IN 46032 USA
31527 UPS ORIGIN Net 30 Days
z2
3702098
ed` `Unit 1"rice mm`
3702098 ) TITAN 5 CARSEAT 509 2PK 4 $ 57.7500 $ 231.00
-------- ------------------------------ LAST ITEM --------------------------'---------------------------------------------------
i
I
I
I
Tracking Numbers: 1ZA7T6670392195508, 1ZA7T6670392454719
Subtotal 231.00
- Freight 36.20
Sales Tax 0.00
Discount 0.00
PLEASE:VO TE,NEW-,,':REM ITTA�CE`.:,R '` Payment/CreditAmount 0.00
°µ .; BalanceAlDue 67.20
INDIANA RETAIL TAX EXEMPT
C1ty z-
of
C sane l CERTIFICATE NO. 03120155 02 0 PAGE
1i PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT M27
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.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
3114J2014
Guild Source Ca mol Police Dopatment
VENDOR otom Roserwo Diet ibuting, Inc. SHIP 31 Civic squm
SM L aho Rd TO C@mol, IN 4
M adinm, Ob 44266 (397)374=2
CONFIRMATION BLANKET I CONTRACT PAYMENT TERMS FREIGHT
Account
��yUNIIT�OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account ild7`iF5iJ.65
1 E@ch shipping charges 533.20 $30.20
4 Each Titan 5 Carseat 3702098 $57.73 $231.00
Sub ToW: $288.20
,IV7�F:
%
I e�
o� /\
Uti`� ° � �
Send Invoice To:
Camol Potico ®�a> me��i
Atte: Past Young
3 Civic Squam
Camel, IN 46932- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Camel Police®rept. � � � 3 PAYMENT W7.20
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT,THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIA N� FFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. �/� ®Ilcia
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE /Chlof 6Jr
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 3 15 2 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO._ WARRANT NO.
ALLOWED 20
IN THE SUM OF$
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
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))
03/18/14 0000224857 car seats $267.20
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Child Source
Western Reserve Distributing, Inc. IN SUM OF $
305 Lake Rd
Medina, OH 44256
$267.20
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Grant Fund
PCO/#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
31527 I 0000224857 I 590.05 I $267.20 I hereby certify that the attached invoice(s), or
Cl 0- bill(s) is (are) true and correct and that the
t/ materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, March 31, 2014
4Z/ Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund