246549 06/17/15 CITY OF J� CARMEL, INDIANA VENDOR: 364768
ONE CIVIC SQUARE SYMBOL ARTS( ` CHECK AMOUNT: $*****2,335.00*
CARMEL, INDIANA 46032 6083 SOUTH 1153 EAST CHECK NUMBER: 246549
OGDENUT 84405 CHECK DATE: 06/17/15
t ETON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4230100 32835 0235265-IN 2,335.00 CHALLENGE COIN
*0235265' Page: I
6083 South 1550 East INVOICE
• ' Ogden,UT 84405 CUSTOMER NO: 00-0006435
INVOICE NUMBER: 0235265-IN
(801)475-6000 INVOICE DATE: 5/29/2015
Tracking Number:
1Z59E99W0374025006 ORDER NUMBER: 0181679
ORDER DATE: 3/30/2015
SALESPERSON: RIFI
SOLD TO: SHIP TO:
Carmel Police Department Carmel Police Department
' Civic Sq 3 Civic Sq
Carmel,IN 46032 Carmel,IN 46032
CONFIRM TO:MIKE DIXON
CUSTOMER P.O. Ship VIA F.O.B. TERMS
UPS GROUND DEST NET 30
ITEM NO. UNIT ORDERED SHIPPED BACK ORD PRICE AMOUNT
XMC18067 EACH 500 500 0 4.50 2,250.00
COIN,1.5"CARMEL PD
C-74503/15-01673
SG: Shipped on: 05/29/2015
Tracking#: 1 Z59E99 W0374025006
Number of Packages:2
Invoice Number
We appreciate your business!
Visit us at www.S-vmbolArts.com
Credit Card Payment Information Net Invoice: 2,250.00
Card Type: Less Discount: 0.00
Credit Card#(Last 4): Shipping/Handling: 85.00
Expiration Date: Sales Tax: 0.00
Amount: 2,335.00 Invoice Total: 2,335.00
NOTE:Past due invoices may be subject to a 1.5%monthly(18%per annum)finance charge.
INDIANA RETAIL TAX EXEMPT PAGE
City ®f Carmel !'I CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 3283
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
4Tt020'l5
SymbolArts, LLC Carmel Police Department
VENDOR SHIP 3 Civic Sguam
3 S. 1550 East TO Catwiel, IN 4603-2
Ogdon, UT 8440 (317)57102;xSQ
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42,' 1.00
1 Each Challenge Coins 2015 (Qtyt 500) $2,336.00 $2,335.00
Sub Taal: $2,335.00
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Send Invoice To: '.
Carmel Police Department
Attn: Pat young
3 Civic Squam
Cannel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cannel Police Dept. ,; zz,.7i.3Jmu
PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
�. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROP)ER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFYT�i T/THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIAT ON SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY /�fcv
SHIPPING LABELS. of police
police
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL No- 32835
A.P.V. COPY-SIGN AND RETURN TO CLERIC'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
SymbolArts, LLC
IN SUM OF$
6083 S. 1550 East
Ogden, UT 84405
$2,335.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
32835 I 0235265-IN I 42-301.00 I $2,335.00 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, June 11, 2015
Chief of Police
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))
05/29/15 0235265-IN challenge coins $2,335.00
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