HomeMy WebLinkAbout250864 10/21/15 r G�9
*f. CITY OF CARMEL, INDIANA VENDOR: 362664
® ONE CIVIC SQUARE T3 MOTION, INC CHECK AMOUNT: S""'""522.74'
CARMEL, INDIANA 46032 970 CHALLENGER ST CHECK NUMBER: 250864
+,;,.TON�` BREA CA 92821 CHECK DATE: 10/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4342100 25856 11.67 POSTAGE
1110 4237000 33043 25856 511.07 DRIVE MOTOR
T3 MOTION, INC Phone: 714-255-0200
970 CHALLENGER STREET
BREA CA 92821
United States
Invoice: 25856 ''' ' y Page: 1 of 1
Date: 9/29/2015
Sold To: Ship To:
City of Carmel City of Carmel
Attn: Pat Young 3 Civic Square
3 Civic Square Carmel IN 46032
Carmel IN 46032
PO Number. 33043 Terms: Net 30 y M �m n F.O.B: ORIGIN
Sales Rep: Doug Rodgers Ordered: 9/8/2015 Ship Via: FedEx Ground
Packing Slip: 18408 Ship Date: 9/29/2015
LSO 19667
US Dollars
cExt:Price�
1 1.00 600-00001 511.07000 EA 511.07
Line Ref. 1 MOTOR, T3
Warehouse Code:Main
PO Number: 33043
Line(1)Miscellaneous Charges��
Description Amount
1.) Shipping 11.67
2 1.00 SH-001-001 0.00000 EA 0.00
Line Ref. 2 SHIPPING & HANDLING
Warehouse Code:Main
PO Number: 33043
y< bht,', _ Total: 522.74 USD
Pa ►nent$Scliedule :fix ,1., ti
_ �4 .
. ..,,�;° ,,,�..._.
1 10/29/2015 522.74
Total 522.74
ARForm:001:00
INDIANA RETAIL TAX EXEMPT PAGE
City ® I' Carniel
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,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
1�4�93
i
73 Motion, Inc. Cool Pollco Dopadmort
VENDOR SHIP 3 CIVIC squm
Almy Avonuo TO CEffn0l, IN 41
Coag@ los@, CA VMS (W)374
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
OUAN'TyIT42-370.00
Y g�q70UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account SIC-3 .0 g 0
1 Each Drive motor $311.07 $311.07
Sub Total: $311.07
�
. 0
Send Invoice To:
C@fmol Pollco Dopmrtmont
Attn: Pat Young
Carmol, IN 4 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Carmel Police Dept, PAYMENT _ .0
• 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 H6r HERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRI - N FFICIENT TO PAY FOR .HE ABOVE ORDER.
•SHIP REPAID. /
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. hlGf of P'ollco
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE Y Y'
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 3304 3 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))
09/29/15 25856 Shipping $11.67
09/29/15 25856 Motor $511.07
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
T3 Motion, Inc.
IN SUM OF $
2990 Airway Avenue
Costa Mesa, CA 92626
$522.74
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 25856 43-421.00 $11.67 I hereby certify that the attached invoice(s), or
�i bill(s) is (are)true and correct and that the
` 33043 25856 42-370.00 $511.07
materials or services itemized thereon for
which charge is made were ordered and
received except
Tuesday, October 06, 2015
01
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund