250618 10/21/15 Qa
CITY OF CARMEL, INDIANA VENDOR: 367134
® ONE CIVIC SQUARE CITY OF WESTFIELD TRAINING CENTERCHECK AMOUNT: $....*8,380.00`
CARMEL, INDIANA 46032 WESTFIELD FIRE DEPARTMENT CHECK NUMBER: 250618
17535 DARTOWN ROAD CHECK DATE: 10/21/15
WESTFIELD IN 46074
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
210 4357000 33199 TF150003 8,380.00 OPERATING EXPENSE
0
RECEIVED
CITY OF OCG?
Westfield OCT 0 5 2015
INDIANA
CARMEL POLICE DcPT.
Mayor _
Andy Cook Westfield Invoice
Fire Department
City Council
Jim Ake DATE: September 30,2015 Invoice # TF-15-0003
_ Steven Hoover
Robert L. Horkay
Chuck Lehman
Robert J.Smith TO:TIM GREEN
Cindy L.Spoljaric POLICE CHIEF
Robert W.Stokes CARMEL POLICE DEPARTMENT
3 CIVIC SQUARE
Clerk Treasurer CARMEL,IN 46032
Cindy J. Gossard
Qty. Description Unit Price Total
Training Center 2015
Operating Expenses $8380.00 $8380.00
MAKE CHECK PAYABLE TO:
City of Westfield Training Center
MAIL PAYMENT TO:
Westfield Fire Department
17535 Dartown Road
Westfield,IN 46074
Attn:Chief Russ Shoaf(Westfield Training Center)
— I
(Fire Department
(317) 804-3030 office
(317) 804-3395 fax
17535 Dartown Road
Westfield, IN 46074
westfield.in.gov
A INDIANA RETAIL TAX EXEMPT PAGE
City of
Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 33192
35-60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, VP
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
City of Wooffield Training Contor CUMG! Dolle®Dapm mont
CHS of Mot loll Clor#s Trmsuror SHIP 3 Civic squam
'VENDOR r
iii TO C`amol, IN/46M
nno
Wmatflo Id, IN 4W4 579
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account:00.670.03
9 Each training center operating expenses $8,380.00 $8,380.00
Sub Total: $8,380.00
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Send Invoice To:
Carmel Police Deparrtmon$
Attn: Pat Young
3 Civic; Squm
Cam ol, IN - PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT 4MOUNT
cumal 1011ce mpt. 2Vab
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.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THATH AE IS AN UNOBLIGATED BALANCE IN
THIS APP�PROPRnIATSUF ICIENTTOPAY FORTHE'•ABOVEORDERSHIP REPAID. teiC.O.D.SHIPMENTS CANNOT BE ACCEPTED. ;i''� •"^ r
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY r _< `+�.*•t�° :a:'::-.;•
SHIPPING LABELS. ciiflGf o Police
Y�•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.> I I r >
s- CLERK-TREASURER
I DOCUMENT CONTROL NO. 3 19 9 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER WARRANT NO.
ALLOWED 20
IN THE SUM OF$
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
...........................................-----------------------------------------------------—-------------------------------------
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))
09/30/15 TF-15-0003 annual payment $8,380.00
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
City of Westfield Training Center
City of Westfield Clerk Treasurer
IN SUM OF $
130 Penn Street
Westfield, IN 46074
$8,380.00
ON ACCOUNT OF APPROPRIATION FOR
CPD Continuing Ed Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
33199 I TF-15-0003 I -570.00 I $8,380.00 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,Yetober 16, 2015
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund