250437 10/07/1 5 �' CITY OF CARMEL, INDIANA VENDOR: 366761
® I ONE CIVIC SQUARE TACTICAL NIGHT VISION COMPANY CHECK AMOUNT: $"..."'703.53`
?� CARMEL, INDIANA 46032 1050 NEVADA ST,STE 405 CHECK NUMBER: 250437
M�roN. REDLANDS CA 92374 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239010 33157 321515G 703.53 MOUNT ASSEMBLY
TNVC INC. Invoice
1050 Nevada St.
Suite 405 Date Invoice#
Redlands, Ca. 92374 9/11/2015 321515-G
Bill To Ship To
Cannel Police Department Carmel Police Department
Ryan Jellison Ryan Jellison
3 Civic Square 3 Civic Square
Carmel,IN 46032 Carmel,IN 46032
P.O. No. Terms Due Date Ship'Via FOB
33157 Net 30 10/11/2015
Q... Item Description Rate Amount
2 NOR-MICH-MNT Norotos MILSPEC USGI MICH Helmet Mount Assembly 204.25 408.50
1 NOR-RIN02-ACH-GH Norotos RHNO 11 Helmet Mount(Bayonet Horn)-Gray 275.50 275.50
1 FedEx FedEx Ground 19.53 19.53
(2)NOR-MICH-MNT FedEx Ground Tracking Number(s):
641924943900 Ship Date:09/11/2015
NOR-RH lO2-ACH-GH shipped FedEx Express Tracking
Number(s):641924946623 Ship Date:09/30/2015
Phone# E-mail Web Site Sales Tax (0.0%) $0.00
(909)796-7000 sales @a tnvc.com http://xNkN,",.tnvc.com
Total $703.53
Export of U.S.manufactured night vision equipment is strictly prohibited without a valid
export license issued by the U.S.Department of State Office of Defense Trade Controls.in
accordance with International Traffic in Arms(ITAR),Title 22,Code of Federal Regulations Payments/Credits $0.00
Part 120-130,and/or the U.S.Department of Commerce.For further information contact the
Office of Defense Trade Control a(202)663-1282 and/or the U.S.Department of �aAaIICe ®fie
Commerce. ® $703.53
INDIANA RETAIL TAX EXEMPT PAGE
City o Carme' l
CERTIFICATE NO.003120155 002 0 1i PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
'URCHASE ORDER DATE DATE REQUIRED REQUISITIONNO. VENDOR NO. DESCRIPTION
TNVC INC C oI palled Dopar tmont
VENDOR SHIP 3 CIVIC squm
IMB Novada Stroot. Bulto 406 TO Camal, IN
Rodt@nds, CA MW4 (397)6711-2M
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
Account
UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Accour t 42-1'UTs.�4J��pp.10
3 Each Woroto$MICH NVG Mount Assam y 5855-01-559-4525 $215.00 W5.00
Sub Total: $646.00
J° °c ..
y
000
Send Invoice To: �~ =
CafmGl PaUco Dopaitmont
Attn: Pat Young
3 CIVIC squm
Wtri@i, IN 2= PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cumel Police Dept. vm.uu--
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 P O SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY T A ERE IS AN UNOBLIGATED BALANCE IN
THIS APP7PR O FFICIENT PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL q
SHIPPING LABELS. C @�aP`a'allco
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 33157 A.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))
09/11/15 321515-G Helmets $703.53
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
TNVC INC
IN SUM OF $
1050 Nevada Street. Suite 405
Redlands, CA 92374
v
$703.53
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
33157 I 321515-G I 42-390.10 I $703.53 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
Friday, October 02, 2015
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund