HomeMy WebLinkAbout234496 07/08/14 `��...4pnyF
* CITY OF CARMEL, INDIANA VENDOR: 361470
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ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $*******908.10*
CARMEL, INDIANA 46032 305 LAKE ROAD CHECK NUMBER: 234496
°M�raN MEDINA OH 44256 CHECK DATE: 07/08/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
900 4359005 32053 0000230394 908.10 CHILD SEATS
MERCURY Invoice
DISTRIBUTING
305 Lake Road,Medina,OH 44256
Ph:330.723.4739 Fax:330.721.6799 Invoice Number: 0000230394
REMITTANCE ADDRESS: Invoice Date: 6/24/2014
WESTERN RESERVE DISTRIBUTING,INC.
dba MERCURY DISTRIBUTING or CHILD SOURCE 7/24/2014
305 LAKE RD Invoice Due Date:
MEDINA,OH 44256 Customer: CARMPD
Tax ID#82-0563593 Sales Order: 0000126697
Sold To`<.: Ship To
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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32053
80.13-32053 UPS ORIGIN Net 30 Days
Item Description Qty Shipped: Unit Price Amount
3702098 TITAN 5 CARSEAT 50#2PK 4 $ 57.7500 $ 231.00
IC068FSM ON BOARD35 INFANT CAR SEAT W/BASE 4 $ 77.4000 $ 309.60
3431198 Chase No Harness 40-110 lbs(I8-49,8kg) 2 $ 26.9500 $ 53.90
Booster Car Seat,Factory Select 2 pack
93-299FSM BACKLESS SHIELDLESS BOOSTER(4 PER 4 $ 14.9000 $ 59.60
PACK)
93-209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 2 $ 47.2000 $ 94.40
-------------------------------------------------------------------- LAST ITEM ---------------------------------------------------------------------------------
Tracking Numbers: 1 ZA7T6670395645427, 1 ZA7T6670395708181, 1 ZA7T6670395815234, 1 ZA7T6670396267245, 1 ZA7T66
Subtotal 748.50
Freight 159.60
Sales Tax 0.00
Discount 0.00
PLEASE NOTE NEW REMITTANCE''. Payment/CreditAmount 0.00
ADDRESS ABOVE B-alance.D_a 908.10
INDIANA RETAIL TAX EXEMPT PAGE
City ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 32053
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
Child Bouxc Carel Police Dapar#nr W,
Wostom Leser Distflbuting, Inc. Civic 5guaFe
VENDOR SHIP
305 Lake !fid TO Cannel, IN 46032
Medina, DH 44256 (3 17)671.2 9
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 008590.05
1 Each shipping charges $159.50 $159.00
2 Each High Back Booster Front Adj 93-209FSM $47.20 $94.40
4 Each BacIdess Shieldless Booster 93-299FSM $14.90 $59.00
2 Each Chase No Hartness Booster $20.95 $53.90
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4 Each On Board35 Infant Car Seat -IC:008F $77.40 $349.60
4 Each Than 5 Carseat `t€ F {37020 8, _ f` > 2
,4* $57.25 $131.OG
4 j « Sub Total: $908,10
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Send Invoice To:
Cannel Police Department
Alan: Pat Young
3 Civic Squam
Can-nel, IN 46OP2- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT ,_ {yIOUNT
Cartrrei Poke Dept. %4 .,;U
PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS' PPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. t
• C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.: Chl@ @y
of Police
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 1
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL No- 32053 A.P.V. COPY-SIGN AND REI URN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
POO 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 J
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
$908.10
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Grant Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
32053 0000230394 -590.05 $908.10 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
Thursday July 03, 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))
06/24/14 0000230394 car seats $908.10
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