HomeMy WebLinkAbout236339 08/27/14 (9,
CITY OF CARMEL, INDIANA VENDOR: 361470
ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: S*"*"**"856.26*CARMEL, INDIANA 46032 305 LAKE ROAD CHECK NUMBER: 236339
MEDINA OH 44256 CHECK DATE: 08/27/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
852 5023990 234236 392.85 OTHER EXPENSES
900 4359005 32425 234236 463.41 CARSEATS
MERCURY Invoice
DISTRIBUTING
305 Lake Road, Medina, OH 44256
Ph: 330.723.4739 Fax: 330.721.6799 Invoice Number: 0000234236
REMITTANCE ADDRESS: Invoice Date: 8/13/2014
WESTERN RESERVE DISTRIBUTING. INC.
dba MERCURY DISTRIBUTING or CHILD SOURCE
305 LAKE RD Invoice Due Date: 9/12/2014
MEDINA.Oil 44256
Customer: CARMPD
Tax ID#82-0563593 Sales Order: 0000128495
Sold To Ship To
CARMEL POLICE DEPARTMENT, CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 OAK RIDGE ROAD
CARMEL, 1N 46032-2584 USA A GALLAGHER 317-571-2720
Carmel, IN 46032 USA
Customer-P.-O.- ----- --- -----Ship-Via,-. ---- --- --F:O.B- -----
32425 UPS ORIGIN Net 30 Days
Item Description Qty Shipped Unit Price Amount
IC068FSM ON BOARD35 INFANT CAR SEAT W/BASE 6 $ 77.4000 $ 464.40
3702098 TITAN 5 CARSEAT 50#2PK 2 $ 57.7500 $ 115.50
93-209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 4 $ 47.2000 $ 188.80
-------------------------------------------------------------------- -- LAST ITEM
Tracking Numbers: 1 ZA7T6670395098788, 1 ZA7T6670395465836, 1 ZA7T6670396351797, 1 ZA7T6670396500410, 1 ZA7T66
Subtotal 768.70
Freight 87.56
Sales Tax 0.00
Discount 0.00
PLEASE NOTE NEIN REMITTANCE Payment/Credit Amount 0.00
ADDRESS ABOVE _Balance-Due 856.26
i
INDIANA RETAIL TAX EXEMPT PAGE
City of Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
: FEDERAL EXCISE TAX EXEMPT 32425
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
014
Child Bourao C@mol Police Oop9artmont
Mstwn Resorwo Diotributing, Inc. SHIP 3 CIVIC squama
VENDOR
SM baso Rd TO C@rmol, IN 4M
Modlnm, Ob 44 (397)671-M
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
i
Account 00-62105 - G^
9 Each shipping $87.50 $87.58
4 Each High(back Booster Front Adj 03-20OFSM $47.20 $188.80
2 Each 'Man 5 Carseat 3702008 $57.75 $115.50
8 Each Qn Board35 Infant Car Seai4 10058 S�A� $77.40 $4 .40
. .
Sub Total: _$860A%.,
o lu
PRES ORMANCE II,INC.
/ romoibnal Marketing 8 Corporate Apparel
wmi presege2online.mm
317-84&2950
O dory 12840501\
Send
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Send Invoice To: a fes—
I \
Carmel Pollco Dop oitmont
Alan: Pat Young
3 Chic squm
Cafnol, IN 41 - PLEASE INVOICE IN DUPLICATE
Dt
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. C j PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS TH�PROPER SWORN AFFIDAVITATWCHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY�T AT THERE IS AN UNO�IGATED BALANCE IN
THIS APPROPR ��J UFFICIENT T FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY g
SHIPPING LABELS. C(47 Io?
Pollco
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE /
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 1
r
CLERK-TREASURER
DOCUMENT CONTROL No- 32425 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
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 motor 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))
08/13/14 234236 car seats $463.41
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
9,5 - 2�v
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Grant Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
32425 I 234236 I -590.05 I $463.41 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
Thursday, August 21, 2014
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund