HomeMy WebLinkAbout242223 02/17/15 o
CITY OF CARMEL, INDIANA VENDOR: 361470
ONE CIVIC SQUARE CHILD SOURCE CHECKAMOUNT: $*******379.55*CARMEL, INDIANA 46032 305 LAKE ROAD CHECK NUMBER: 242223
MEDINA OH 44256 CHECK DATE: 02/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
900 4359005 32753 246658 379.55 CAR SEATS BOOSTER
-qovMERCURY Invoice
DISTRIBUTING
305 Lake Road, Medina, OH 44256
Ph: 330.723.4739 Fax:330.721.6799 Invoice Number: 0000246658
REMITTANCE ADDRESS:
WESTERN RESERVE DISTRIBUTING. INC. Invoice Date: 2/3/2015
dba MERCURY DISTRIBUTING or CHILD SOURCE
305 LAKE RD Invoice Due Date: 3/5/2015
MEDINA.OH 44256
Customer: CARMPD
Tax ID#82-0563593 Sales Order: 0000135344
Sold To Ship To
CARMEL POLICE DEPARTMENT, CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 W 146TH STREET
CARMEL, IN 46032-2584 USA 317 571 2720
Cannel, IN 46032 USA
-- --_Customer.P.O-_ _-_ Ship,Via- .___. --_>�-_ _.___-� F.O.B _-
32753 UPS ORIGIN Net 30 Days
Item DescriptionQty Shipped Unit Price Amount
IC068FSM ON BOARD35 INFANT CAR SEAT W/BASE 2 $ 77.4000 $ 154.80
3702098 TITAN 5 CARSEAT 50#2PK 2 $ 57.7500 $ 115.50
3431198 Chase No Harness 40-110 lbs(18-49,8kg) 2 $ 26.9500 $ 53.90
Booster Car Seat, Factory Select 2 pack
-- ---------------------------------------- LAST ITEM ---------------------------------------------------------------------------------
,I
Tracking Numbers: 1 ZA7T6670395920629, 1 ZA7T6670396363604, 1 ZA7T6670396805010, 1 ZA7T6670398472395
Subtotal 324.20
Freight 55.35
Sales Tax 0.00
Discount 0.00
PLEASE NOTE NEIN REMITTANCE Payment/CreditAmount 0.00
ADDRESS ABOVE Balance-Due 379.55
INDIANA RETAIL TAX EXEMPT PAGE
City ®f Carmel CERTIFICATE NO.003120155 002 0 PU FrASE 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.
PI RC ,`Sg YDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
Child ]��
Ott Pollen Donvirtmgnt
W@sl:GM RGG@rVG DIMbuting, Inc. 3 CIVIC aqu@ro
VENDO L2ho Rd SHIP C@Mol, IN 4
Modina, Ob 442M TO (397)571
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
�T NI F MEASURE DESCRIPTION UNIT PRICE EXTENSION
j 1 Each slipping charges $95.35 $55.35
2 Each Chase No Harness Booster 3431198 $23.95 $53.90
2 Each Titan 5 Carzeat 3702098 $57.75 $115.50
2 Each On Board35 Infant Car Seat IC068FSM $77.40 $154.80
Bub Yotol: $379.55
J
---
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•4 e
Send
Attn: Pat Young
3 Civic Squm
Cin@I, IN 4m-
PLEASE INVOICE IN DUPLICATE
Garmel agrFFrT &7rg. ACCOUNT PROJECT PROJECT ACCOUNT 7 MOUNT
PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF TH=VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPE WORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT FRE IS AfUFIDBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATIO FI &!T: TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY e Pollen
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
^ CLERK-TREASURER
DOCUMENT CONTROL NO. 23 A.P.V. COPY-SIGN AND RETURN TO CLERIC'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF $
e �9
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
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))
02/03/15 246658 car seats $379.55
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
$379.55
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Grant Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
7 I I I 1 hereby certify that the attached invoice(s), or
32753 246658 -590.05 $379.55
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
Tuesday,,Fbruary 10, 2015
4Z Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund