HomeMy WebLinkAbout231610 04/23/14 CITY OF CARMEL, INDIANA VENDOR: 361470 CHECK AMOUNT: S""""618.40'
® ONE CIVIC SQUARE CHILD SOURCE
CARMEL, INDIANA 46032 305 LAKE ROAD CHECK NUMBER: 231610
MEDINA OH 44256 CHECK DATE: 04/23/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
900 4359005 31949 226257 618.40
----OVMERCURY Invoice
DISTRIBUTING
305 Lake Road, Medina, OH 44256
Ph: 330.723.4739 Fax: 330.721.6799 Invoice Number: 0000226257
REMITTANCE ADDRESS: Invoice Date: 4/9/2014
WESTERN RESERVE DISTRIBUTING. INC.
dba MERCURY DISTRIBUTING or CHILD SOURCE 5/9/2014
305 LAKE RD Invoice Due Date:
NIEDINA,OH 44256
Customer: CARMPD
Tax ID#82-0563593 Sales Order: 0000124936
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CARMEL POLICE DEPARTMENT, CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 OAKRIDGE ROAD
CARMEL, IN 46032-2584 USA Carmel, IN 46032 USA
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31949
Via `E.:C)'13.. e3 Terms
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31949 UPS ORIGIN Net 30 Days
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S1ii ed'.: rh it Price An�aunt".
. ... .1Pi? mow.
IC068FSM ON BOARD35 INFANT CAR SEAT W/BASE 2 $ 77.4000 $ 154.80
3702098 TITAN 5 CARSEAT 50#2111K 2 $ 57.7500 : $ 115.50
93-209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 2 $ 47.2000 $ 94.40
3431198 Chase No Harness 40-110 lbs(I 8-49,8k0 4 $ 26.9500 $ 107.80
Booster Car Seat, Factory Select 2 pack
- -----------
LAST ITEM ---------- ------------= ----------- --------------------- ------
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Tracking Numbers: 1 ZA7T6670390407363, 1 ZA7T6670390695329, 1 ZA7T6670390724136, 1 ZA7T6670392629745, 1 ZA7T66
Subtotal 472.50
Freieht 145.90
Sales Tax 0.00
Discount 0.00
Ptj�AaSEA �� `:
INDIANA RETAIL TAX EXEMPT PAGE
City of
Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 39
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
417=4
Child Roum Carmel Police Depodment
VENDORWastam Resom DIotdbuting, Inc. SHIP 3 Civic squam
L@ho Rd TO Camel, IN 4m
Medina, Ob 44 (397)579=
CONFIRMATION BVUNTIT
CONTRACT PAYMENTTERMS FREIGHT
I
QUANTITYOF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 0040.06
9 Each shipping charges $945.90 $945.90
4 Each Chose No Harness Booster 3439908 $28.05 $907.80
2 Each High Back Booster Front Adj r-20QFSM $47.20 $94.40
2 Each Titan 5 Carseat 5 { 37_ 9�.08a; r� ' $57.75 $115.50
2 Each On i3oard35 Infant Car Seat C008 �
, �;,:. 5' 7.40 $954.80
z r,. $ , ..t .. sub TotW: $898.40
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Send Invoice To:
Carmel Police Depaitment
Attn: Pat Young
3 Civic Squm
I
Carmol, IN mm. PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Cannel Police Dept. PAYMENT $518.40
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER G7WORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT/THE F7E IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION�FI'CIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL g�
SHIPPING LABELS. - � Police
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE m
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL No- 31949 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.----
ALLOWED 20
IN THE SUM OF$
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 except
20
-------------------------..._-...._-------------------------------------------------------------------
Signature
---- --------- - ------- ----------- Title
Cost distribution ledger classification if
claim paid rnotor vehicle highway fund
i
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))
04/09/14 0000226257 car seats $618.40
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
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Child Source
Western Reserve Distributing, Inc. IN SUM OF $
305 Lake Rd
Medina, OH 44256
$618.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Grant Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
31949 I 0000226257 I -590.05 $618.40
I 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
Friday, April 18, 2014
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund