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Home My WebLink About248763 08/26/15 °�'CONN CITY OF CARMEL, INDIANA VENDOR: 361470 d `'1 ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $*******712.24* :.. =4 CARMEL, INDIANA 46032 305 LAKE ROAD CHECK NUMBER: 248763 9.,;,,TON G°` MEDINA OH 44256 CHECK DATE: 08/26/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 852 5023990 33016 0000261679 228.49 CAR SEATS 900 4359005 33017 0000261679 483.75 CAR SEATS MERCURY Invoice DISTRIBUTING 305 Lake Road, Medina, OH 44256 Ph:330.723.4739 Fax: 330.721.6799 Invoice Number: 0000261679 REMITTANCE ADDRESS: Invoice Date: 8/6/2015 WESTERN RESERVE DISTRIBUTING. INC. dba MERCURY DISTRIBUTING or C141LD SOURCE 305 LAKE RD Invoice Due Date: 9/5/2015 MEDINA.OH 44256 Customer: CARMPD Tax ID#82-0563593 Sales Order: 0000143719 old To SShip To CARMEL POLICE DEPARTMENT,CITY TRINITY CLINIC 3 CIVIC SQUARE 1045 W 146TH ST SUITE B CARMEL, IN 46032-2584 USA ATTNANN GALLAGHER Carmel, IN 46032 USA ._ Cr7 —F-.O. - - --- -- --- ustomer :U.- Stiip Via -` - _- -- - -� B 33016&33017 UPS ORIGIN Net 30 Days Item Description Qty Shipped Unit Price Amount 3062198 (Chase Factory Select Harnessed Booster Car Seat 2 8 $ 47.1000 $ 376.80 pack 3431198 Chase No Harness 40-110 lbs(I8-4%8kg) 4 $ 26.9500 $ 107.80 Booster Car Seat, Factory Select 2 pack 3702098 TITAN 5 CARSEAT 509 2PK 2 $ 57.7500 $ 115.50 ---------------------------- --------- LAST ITEM Tracking Numbers: 1 ZA7T6670390798647, 1 ZA7T6670392044984, 1 ZA7T6670392053009, 1 ZA7T6670392560229, 1 ZA7T66 Subtotal 600.10 Freight 112.14 Sales Tax 0.00 Discount 0.00 PLEASE NOTE NEW REMITTANCE Payment/CreditAmount 0.00 ADDRESS ABOVE Balance-Due 712.24 INDIANA RETAIL TAX EXEMPT PAGE City ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT4�` 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 G0w995 Child Roane Cmool Police Depatmont MQom R000rvo Dlotdbuting, Inc. SHIP 3 Civic squm VENDOR L@SG Rd TO C@mGI, IN Modim, Ob 44ZS ��99�X81 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 00-MOS 9 Each car se@ls M83.75 U83.75 Sub Total: $483.75 r0fdronco quatO 6880014371 Send Invoice To: Cumol Pollee Depar�mGnt Attn: PO Young 3 Civic squm Cool, IN PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT 1yomol Police Dept. �c 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 T AT THERE IS AN UNOBLIGATED BALANCE IN SHIPPING INSTRUCTIONS THIS APPROPR.TI N�SUFFICIENTTO PAY FOR THE ABOVE ORDER. •SHIP REPAID. // •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY / / •PURCHASE ORDER NUMBER MUST APPEAR ON ALL /� SHIPPING LABELS. hIG ofP®llee •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE o� AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK-TREASURER DOCUMENT CONTROL NO. 33017 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO._ WARRANT NO.- ALLOWED 20 IN THE SUM OF $ 0 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 INDIANA RETAIL TAX EXEMPT PAGE City ®f .)qarmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER ' FEDERAL EXCISE TAX EXEMPT mois 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 Child Baum Czmol Pollco DGp2orfnont VENDOR SHIP 3 CIVIC squm 8001 Wo®stor PING TO Cool, IN 4 Madsm, OH 44M 571 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account W-W2.0 1 Each car seats $313.90 $313.90 Sub Total: $313.90 �� "�>• I ( 00 r0forGnco quota 0 0000143719 00 � Send Invoice To: y(' Atte: P@t Young Cumol, IN 4m- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT ,armel Police Dept. �ls PAYMENT - UM • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. Iv, NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT�THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. •SHIP REPAID. C.O.D.SHIPMENTS CANNOT BE ACCEPTED. •PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY - ,�a ,,g SHIPPING LABELS. �lldl pollco •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK-TREASURER DOCUMENT CONTROL NO- 33016 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT ALLOWED 20 IN THE SUM OF$ ON ACCOUNT OF APPROPRIATION FOR f C: 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)) 08/06/15 0000261679 car seats $483.75 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. ALLOWED 20 Child Source Western Reserve Distributing, Inc. IN SUM OF $ 305 Lake Rd Medina, OH 44256 �71z2L, ON ACCOUNT OF APPROPRIATION FOR Carmel Police Grant Fund PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 33017 I 0000261679 I -590.05 I $483.75 1 hereby certify that the attached invoice(s), or bill(s) is (are)true and correct and that the '�J 2- Z7, materials or services itemized thereon for which charge is made were ordered and received except Thursday, August 20, 2015 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund