247971 07/28/15 "F� CITY OF CARMEL, INDIANA VENDOR: 365201
® `ii ONE CIVIC SQUARE NOVELTY INC CHECK AMOUNT: $**.....162.35*
CARMEL, INDIANA 46032 4924 RELIABLE PARKWAY CHECK NUMBER: 247971
9.y,roN,�,�� CHICAGO IL 60686-0049 CHECK DATE: 07/28/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4345002 32989 10172780-00 162.35 PROMO ITEMS
Ki
vo
491 Est MUSKegon Drive K N V 0 U ~ E
Greenfield,
IN 46140-8575
(8OO)428'1153(8OO) Fax: (8O0)832'5477 INVOICE DATE INVOICE NO.
vwxmv.kipptoyo.00m
07/08/15 10172780-00
oust x*muo
Ship To: Carmel Police Department
3 Civic Sq Remit To: Nnve|h/. Inc.
Carmel, IN 46032'2584 4924 Reliable Parkway
Chicago, \L�DUB8'0040
Bill To: Carmel Police Department '
3Civic Sq
Carmel, IN 46032-2584
INSTRUCTIONS SHIP POINT VIA SHIPPED TERMS
Novelty FedX Ground 07/08/15 Net 30
IP
SELL =PRICE
ITEM AND DESCRIPTION OIDEIE SH PE t
1 na 3336 10 10 BX 11.95 BX 0.00 119.50
SILLY SQUEEZE DUCKS BX 24 PCS
2 029019 1 1 GR 17.9496 GR 0.00 17.95
CRAZY BOUNCE BALL ASSORTMENT
3 nb 9830 1 1 BG 2.9498 BG 0.00 2.95
FUNKY HEART TATTOOS BG = 72PCS
4 nb 4996 1 1 GR 5.9500 GR 0.00 5.95
4 Lines Total Qty Shipped Total is Total 146.35
8 Freight<$75 16.0
Invoice Total 162.3
Tracking #'s - 563567571108022
Cash Discount 0.00 If Paid By 07/08/15
Signature:
�1 INDIANA RETAIL TAX EXEMPT PAGE
City ®f Carme
�� �} � CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
i s FEDERAL EXCISE TAX EXEMPT SLC� 1�1 1�11A
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
f 1f y YLV l J
Kipp Tom Cmrmol P®IIc®Dopaitntont
Nov@1tlf, Inc. SHIP 3 Civic squma
VENDOR p►
M I�GIiabIG Pmff ay TO C GI, IN
Chicago, IL 6=4M (3v)6Ti
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43 .02
10 Each Silly squeezo ducks NA 3330 $91.95 $999.30
�T .tet— yua�Ard �ra.w ,.
it
.:
i �
s g \'<
20-
\tel
p
Send Invoice To.` '� / >,
;'r,.� `•'ter-=; '!i j
id of Pollco Doputment msµ,,• .., :: �
Attn: Pat Young
3 CIVIC squm
CGI, IN 432- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
-awe FFolk®uept- �3 PAYMENT :01
• U
• 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.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
•
SHIP REPAID. PPRP THIS AN4SUFFICIENT TO,PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. IOYq of
Pollco
�t •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL No- 32989A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
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))
07/08/15 10172780-00 promotional give aways $162.35
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
Kipp Toys
IN SUM OF $
Novelty, Inc.
4924 Reliable Parkway
Chicago, IL 60686-0049
$162.35
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
iPO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
32989 I 10172780-00 I 43-450.02 I $162.35 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, July 23, 2015
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund