HomeMy WebLinkAbout248270 08/1 2/1 5 �/ CITY OF CARMEL, INDIANA VENDOR: 361470
�' ` . 0CHECK AMOUNT: $**""1,024.90•
(b 4 ONE CIVIC SQUARE DCE 51LAKES ROAD CHECK NUMBER: 248270
_;, ? CARMEL, INDIANA 46032 MEDINA OH 44256 CHECK DATE: 08/12/15
MUTON�;
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
900 4359005 33000 260189 1,024.90 CARSEATS BOOSTER
MERCURY Invoice
DISTRIBUTING
305 Lake Road,Medina,OH 44256
Ph:330.723.4739 Fax:330.721.6799 Invoice Number: 0000260189
REMITTANCE ADDRESS: Invoice Date: 7/21/2015
WESTERN RESERVE DISTRIBUTING,INC.
dba MERCURY DISTRIBUTING or CHILD SOURCE 8/20/2015
305 LAKE RD Invoice Due Date:
MEDINA,OH 44256 Customer: CARMPD
Tax ID#82-0563593 Sales Order: 0000142900
Sold To' Ship To
CARMEL POLICE DEPARTMENT, CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 W 146TH STREET
ATTN PAT YOUNG SUITE B
CARMEL,IN 46032-2584 USA Carmel,IN 46032 USA
i CustomerP.O. �� -_=ShiVia __ _�,__ -moi F.O =—. _. :. - -- -terms
33000 UPS ORIGIN Net 30 Days
Item Description Qty Shipped Unit Price Amount
IC068FSM ON BOARD35 INFANT CAR SEAT W/BASE 2 $ 77.4000 $ 154.80
3702098 TITAN 5 CARSEAT 50#2PK 8 $ 57.7500 $ 462.00
3062198 Chase Factory Select Harnessed Booster Car Seat 2 6 $ 47.1000 $ 282.60
pack
--------------------------------------------------------------------------------- LAST ITEM --- --------------------------------------------------------------------
i
Tracking Numbers: 1 ZA7T6670395672424, 1 ZA7T6670395683476, 1 ZA7T6670397582232, 1 ZA7T6670398043401, 1 ZA7T66
Subtotal 899.40
Freight 125.50
Sales Tax 0.00
Discount 0.00
PLEASE NOTE NEW REMITTANCE
Payment/Credit 0.00
,k ADDRESS ABOVE _ Balance_Due 1,024.90
INDIANA RETAIL TAX EXEMPT PAGE
City ®fCarmel
CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT am
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
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
711 6I G
Child Soume Carmel Police Department
@otern R@s9fvo Distllbuting, Inc. SHIP 3 CNIC Square
VENDOR
306 Lake Rd TO Carm@l, IN 46032
Medina, O?1H 442 (397)571-2559
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY I UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 00-690.15
1 Eacli shipping changes $125.50 $125.50
6 Each Chase Factory Select Harnessed 3002108 $47.10 $282.60
Booster
8 Each Titan 5 Carseat '3702093----_ $51.75 $462.00
2 Each On Board35 Infant Cir Seat r 1r l'IG4 $77.40 $154.00
tjr-
Sub Total: $1,024.00
a ! k} I)
J
{{t om ' r r I h "„ , � • ate 7{I
quote 0000142900
1
Send Invoice To:
Carmel Police Department
Attn: Pat'young
3 Civic Square
Carmel, IN 461:132= PLEASE INVOICE IN DUPLICATE
DEPARTMENT ,, ACCOUNT PROJECT PROJECT ACCOUNT AM NT
Ca imel Police Dept. �, - 3 4'Uz4. r
PAYMENT
rA/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THlTTyARE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATIONiSUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL J,/ �y
SHIPPING LABELS. C"f of p ollc@
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO- 330 00 A.P.V. COPY-SIGN AI'"ID RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
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
--- --. ------- Title -
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
Child Source
Western Reserve Distributing, Inc.
' IN SUM OF$
305 Lake Rd
Medina, OH 44256
$1,024.90
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Grant Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
33000 I 0000260189 I -590.05 I $1,024.90 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
Thursday, August 06, 2015
7
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
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s)or bill(s))
07/21/15 0000260189 car seats $1,024.90
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