246879 06/30/15 a CITY OF CARMEL, INDIANA VENDOR: 178620
® ONE CIVIC SQUARE KUSTOM SIGNALS, INC CHECK AMOUNT: $*—*'"809.00*
?� CARMEL, INDIANA 46032 PO Box 411882 CHECK NUMBER: 246879
ATTN:ACCTS REC CHECK DATE: 06/30/15
KANSAS CITY MO 64141-1882
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350000 32800 510945 133.00 RADAR REPAIRS
1110 4350000 32868 513690 676.00 RADAR REPAIR
Invoice Number 510945
KUSTOM SIGNALS INC. 1111111111111111111
I
A PUBLIC SAFETY EQUIPMENT COMPANY REMIT TO: Invoice Date 03/11/15 1010 W.Chestnut/P.O. Box 947 KUSTOM SIGNALS, INC. Customer Number 16673
Chanute, KS 66720-0947 PO BOX 411882 Order Number 202185 SR
(620)431-2700 Fax(620)431-2734 KANSAS CITY, MO 64141-1882 Customer PO 32800
Page 1 of 1
SOLD TO SHIP TO
CARMEL POLICE DEPT CARMEL CLAY COMMUNICATIONS
POLICE DEPT HDQTRS CENTER
3 CIVIC SQUARE 31 1ST AVE NW
CARMEL IN 46032 CARMEL IN 46032
Net Due Date 04/10/15 Terms net 30 Shipping UPS
Quantity Part Number DESCRIPTION Serial # Price Extended
Shipped Price
1 200-2072-OOR PRO-LITE REPAIR
LP03014
OW 7-22-09
Recalibration only
Brian Smith 317-571-2594
bmsmith@carmel.in.gov
.......EST..........
1 TRACKING DATE SUMMARY FOR THIS REPAIR
DATE RECEIVED 2-26-15
POHOLD 2-26-15
Technician Start/End Date:2/27/2015
Technician Start/End Date:3/3/15
Emailed estimate 3/5/15
Estimate approved 3/9/15
Technician Start/End/Repair Date:3/11/15
1 888-8888-33 CS FREIGHT GROUND 18.00 18.00
OUTBOUND SHIPPING
18 111-1111-11 OOW Laser Labor tenths of hr
COW Laser Labor tenths of hr
Pro-Lite Laser Serial#LP03014 Assessment Finding:
Customer has specified(RECERTIFICATION ONLY)
Regression test found NO minor or major operating inadequacy
Completed verify functions check HUD realignment/Road Test
Recertified
1 222-2312-01 CS ROAD TEST ASSESSMENT
5 111-1111-11 OOW Laser Labor tenths of hr
OOW Laser Labor tenths of hr
7mm TOTAL Pulse Width PRF Calibration
19.08 141.5 29.8 200 20.000024
1 222-2320-00 RECERTIFICATION, PRO-LITE+ 115.00 115.00
REMIT TO: FEDERAL ID# 43-1757730 Subtotal 133.00
KUSTOM SIGNALS, INC. III IIIIIlllilllllllllllll 111 %Tax 0.00
PO BOX 411882
KANSAS CITY, MO 64141-1882 WWW.KUSTOMSIGNALS.COM TOTAL 133.00
Invoice Number 513690
KUST®M SIGNALS INC. 1111111111111111111
Invoice Date 05/12/15
A PUBLIC SAFETY EQUIPMENT COMPANY REMIT TO: Customer Number 16673
1010 W.Chestnut/P.O. Box 947 KUSTOM SIGNALS, INC.
Chanute, KS 66720-0947 PO BOX 411882 Order Number 203021 SR
(620)431-2700 Fax(620)431-2734 KANSAS CITY, MO 64141-1882 Customer PO 32868
Page 1 of 1
SOLD TO SHIP TO
CARMEL POLICE DEPT CARMEL CLAY COMMUNICATIONS
POLICE DEPT HDQTRS CENTER
3 CIVIC SQUARE 31 1ST AVE NW
CARMEL IN 46032 CARMEL IN 46032
Net Due Date 06/11/15 Terms net 30 Shipping UPS
Quantity Part Number DESCRIPTION Serial # Price Extended
Shipped Price
1 200-2072-OOR PRO-LITE REPAIR
LP02221
OW 3-2-09
Self Test Fail
Brian Smith 317-571-2594
bmsmith@carmel.in.gov
......EST----
1 TRACKING DATE SUMMARY FOR THIS REPAIR
DATE RECEIVED 4-20-15
POHOLD 4-20-15
Technician Start/End Date:4/22/2015
Technician Start/End Date:4/23/2015
Technician Start/End Date:5/4/2015
Emailed estimate 5/4/15
Estimate approved 5-8-15
Technician Start/End Repair Date:5/8/2015
1 888-8888-33 CS FREIGHT GROUND 18.00 18.00
OUTBOUND SHIPPING
38 111-1111-11 COW Laser Labor tenths of hr
COW Laser Labor tenths of hr
Pro-Lite Laser Serial#LP02221 Assessment Finding:
Evaluation ALL main components current over specifications
Examination concluded Control ler,Transmitter,Receiver BER
Prevent-maintenance exchange client's existing Pro-Lite unit
1 222-2320-10 EXCHANGE PRO-LITE+ 658.00 658.00
1 222-2312-01 CS ROAD TEST ASSESSMENT
5 111-1111-11 OOW Laser Labor tenths of hr
COW Laser Labor tenths of hr
7mm TOTAL PW PRF Calibration
17.87 150.0 23.5 200 19.999783
REMIT TO: FEDERAL ID# 43-1757730 Subtotal 676.00
KUSTOM SIGNALS, INC. III IIIIIIIIIIIIIIIIIII I�III %Tax 0.00
PO BOX 411882
KANSAS CITY, MO 64141-1882 WWW.KUSTOMSIGNALS.COM TOTAL s7s.00
City
oINDIANA RETAIL TAX EXEMPT PAGE 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
Mot= Bignals3 CWMGI Pollee DGpaftmGfwt
VENDOR SHIP 3 CIVIC squm
P.O. Box 499 2 TO CUMGI, IN 4M
KmasCity, 90 64141 A 2
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43-M.00
1 Each radar repair $070.00 $076.00
Sub Total: $070.00
21
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Send Invoice To:
C&3r 9Gl PoileG�►Gp�l etGl�4 °d
Alan: Pat Young
3 CIVIC squama
CEmel, IN 4=- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ' ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Camel Police Dept. ` PAYMENT
\, A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
• I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIPPING INSTRUCTIONS
SHIP REPAID. /A �,
THIS APPROPRI T N UFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. hloq oq Pollci ro
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 8 A.P.V. COPY-SIGN AND•RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.__
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO, ACCT#JTITLE 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))
03/11/15 510945 radar repair $133.00
05/12/15 513690 radar repair $676.00
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
VOUCHER NO. WARRANT NO.
Kustom Signals ALLOWED 20
IN SUM OF $
P.O. Box 411882
Kansas City, MO 64141-1882
$809.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
32800 510945 43-500.00 $133.00 1 hereby certify that the attached invoice(s), or
bills) is (are)true and correct and that the
32868 513690 43-500.00 $676.00
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday, June 25, 2015
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund