HomeMy WebLinkAbout238785 11/05/14 (9,
CITY OF CARMEL, INDIANA VENDOR: 361470
ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $**'*'**467.80'
CARMEL, INDIANA 46032 305 LAKE ROAD CHECK NUMBER: 238785
MEDINA OH 44256 CHECK DATE: 11/05/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
900 4359005 32483 0000239285 467.80 CARSEATS
RDMERCURY Invoice
- DISTRIBUTING
305 Lake Road,Medina,OH 44256
Ph:330.723.4739 Fax:330.721.6799 Invoice Number: 0000239285
REMITTANCE ADDRESS: Invoice Date: 10/22/2014
WESTERN RESERVE DISTRIBUTING,INC.
dba MERCURY DISTRIBUTING or CHILD SOURCE Invoice Due Date: 11/21/2014
305 LAKE RD
MEDINA,OH 44256 Customer: CARMPD
Tax ID#82-0563593 Sales Order: 0000131197
Sold To Ship To
CARMEL POLICE DEPARTMENT,CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 W 146TH ST
CARMEL,IN 46032-2584 USA Carmel,IN 46032 USA
�•Custome P:O. - - .i: .. hip Via=——= _ . . :_— _ _F:O B_ - _.- Terms
32483 UPS ORIGIN Net 30 Days
Item Description Qty Shipped Unit Price Amount
IC068FSM ON BOARD35 INFANT CAR SEAT W/BASE 3 $ 77.4000 $ 232.20
3702098 TITAN 5 CARSEAT 50#2PK 2 $ 57.7500 $ 115.50
3701198 TITAN 5 CARSEAT 50# 1PK 1 $ 57.7500 $ 57.75
--------------------------------------------------------------------------------- LAST ITEM ---------------------------------------------------------------------------------
Tracking Numbers: 1ZA7T6670395454044, 1ZA7T6670396219207, 1ZA7T6670397132610, 1ZA7T6670397706036, 1ZA7T66
Subtotal 405.45
Freight 62.35
Sales Tax 0.00
Discount 0.00
PLEASE NOTE NEW REMITTANCE Payment/CreditAmount 0.00
ADDRESS ABOVE r":=r__Bal Can a Due 467.80
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INDIANA RETAIL TAX EXEMPT ` PAGE
City ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
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
a0114rA14
Child Bounce Carmel Police Department
Western) Reserve Distributing, Inc.
VENDOR SHIP 3 CIVIC equa�
Lake Rd TO Cartmel, IN 46032-
Medina, Oil 44266- (317)579 2553
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
3 Each 4n Qeard35 lnfdnt Czar Seat ICOg3FSM $77.40 $232.24
2 Each Titan 5 Carseat 3702008 $57.75 $115,50
1 Each Titan 5 Carseat 5W 3701108 $57.75 $57.75
1 Each shipping $62.35 $02.35
( +..,„.r....,.
#
411
Send Invoice To:
�—
Carmel Police DIspartment
Attn: Pat Young
3 Civic Square
Cannel, IN 461 2` PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Camial Police Dept. -590,05 PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPE S .ORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT T�ER�IS AN UNOBLIGATED BALANCE IN
•
THIS APPROPRI�N•-S FFUC(ENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUSTAPPEAR ON ALL ORDERED BY
SHIPPING LABELS. Ch of Police
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 32483 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
I
VOUCHER NO. _WARRANT NO.
ALLOWED 20
IN THE SUM OF$
I
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
I{ Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO. j
ALLOWED 20
Child Source 1
IN SUM OF$
:3o 57( a-�
7001 Weest&-Pike—
Medina, OH 44256
$467.80
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ON ACCOUNT OF APPROPRIATION FOR
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Carmel Police Gift Fund
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
32483 0000239285 -852.00 $467.80 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
Monda
Y, November 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
i
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
10/22/14 0000239285 Car Seats $467.80
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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