HomeMy WebLinkAbout237801 10/08/2014 (9,
CITY OF CARMEL, INDIANA VENDOR: 361470
ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $**`**1,491.50'
CARMEL, INDIANA 46032 305 LAKE ROAD CHECK NUMBER: 237801
MEDINA OH 44256 CHECK DATE: 10/08/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
900 4359005 32476 0000237650 1,491.50 CAR SEATS
MERCURY Invoice
DISTRIBUTING
305 Lake Road,Medina,OH 44256
Ph:330.723.4739 Fax:330.721.6799 Invoice Number: 0000237650
REMITTANCE ADDRESS: Invoice Date: 9/29/2014
WESTERN RESERVE DISTRIBUTING,INC.
dba MERCURY DISTRIBUTING or CHILD SOURCE 10/29/2014
305 LAKE RD Invoice Due Date:
MEDINA,OH 44256
Customer: CARMPD
Tax ID#82-0563593 Sales Order: 0000129826
Sold To Ship To j
CARMEL POLICE DEPARTMENT,CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 OAK RIDGE ROAD
CARMEL,IN 46032-2584 USA Carmel, IN 46032 USA
32476 LTL-ESTES ORIGIN Net 30 Days
-Item Description Qty Shipped Unit Price Amount i
IC068FSM ON BOARD35 INFANT CAR SEAT W/BASE 3 $ 77.4000 $ 232.20
3702098 TITAN 5 CARSEAT 50#2PK 8 $ 57.7500 $ 462.00
93-209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 6 $ 47.2000 $ 283.20
3431198 Chase No Harness 40-110 lbs(18-49,8kg) 8 $ 26.9500 $ 215.60
Booster Car Seat,Factory Select 2 pack
--------------------------------------------------------------------------------- LAST ITEM ---------------------------------------------------------------------------------
Tracking Numbers: 155-1782307
Subtotal 1,193.00
Freight 298.50
Sales Tax 0.00
Discount 0.00
PLEASE NOTE NEW REMITTANCE Payment/CreditAmount 0.00
ADDRESS ABOVE C __—Ralance Due 1,491.50
City
INDIANA RETAIL TAX EXEMPT PAGE
®� Carmel -CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
111111
FEDERAL EXCISE TAX EXEMPT 476
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
WTAfdFZU1
Child Source Carmel Police Department
+Western Rawve Distributing, Inc. 3 CIVIC SquaF@
VENDORS IP
5 Lake Fid TOCarmel, IN 46432
Medina, OH 442556 (317)571-25659
coNFiaMnnoN
n BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY I UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
A CCOUnt 00-b90.05
1 Each shipping $298.50 $298.50
8 Each Chase No harness waster 3431198 $26.95 $216.60
6 Each High Luck Booster Front Adj 03-209FSM $47.20 $283.20
8 Each Titan 5 Carseat 50# 3701498 . _ $57.75 $462.00
3 Each On Bcard35 Infant Car Seat $77.40$77.40 $232.20
Sub Total: $1,491.50
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Send Invoice To:
Carmel Polio Department
Attn: Pat Young
3 Civic Square
Carmel, IN 46432-
PLEASE INVOICE IN DUPLICATE
4^nrves�E D,EPAR�M I IT ACCOUNT PROJECT PROJECTACCOUNT $j A AMOUNT
PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPE !SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THA/{{TH/RE IS AN UNOBLIGATED BALANCE IN
THIS,PPROPRIATION/U�47
ICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. / I
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL chlbt ORDERED BY
SHIPPING LABELS. d'J P�IIc.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
�
CLERK-TREASURER
DOCUMENT CONTROL NO. 324 7 6 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
1N THE SUM OF$
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
I
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
Child Source 3614 ryo
ALLOWED 20
Western Reserve Distributing, Inc. IN SUM OF$
305 Lake Rd
Medina, OH 44256
$1,491.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Grant Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
I hereby certify that the attached invoice(s), or
32476 0000237650 -590.05 $1,491.50
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
Frida , ctober 03, 2014
Chief of Police
Title
1
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))
09/29/14 0000237650 Car Seats $1,49150
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