251276 11/04/15 y p,_CAAy
CITY OF CARMEL, INDIANA VENDOR: 369955
�y `�l CHECK AMOUNT: $"'"'""460.00"
.� ® �• ONE CIVIC SQUARE U.S.SPECIALITIES
s. ,=a: CARMEL, INDIANA 46032 2205 RIVER ROAD CHECK NUMBER: 251276
9M'roN.��. LOUISVILLE KY 40206 CHECK DATE: 11/04/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4235000 33204 54269 460.00 CORNER GUARDS
l-
INVOICE NO.
MS PEC I ALT I E SO INVOICE
54269
Trademark of The Paul Bickel Company,Incorporated
"CONSTRUCTION PRODUCTS"
2205 River Road• Louisville,Kentucky 40206
PH.(502)587-9000 • FAX(502)587-1032
soTO s CARMEL POLICE TIO CARMEL POLICE
3 CIVIC SQUARE 3 CIVIC SQUARE
CARMEL, IN 46032 CARMEL, IN 46032
ACCOUNT NO. SALES PURCHASE ORDER NO. SHIP VIA COLL. PPD. DATE SHIPPED TERMS INVOICE DATE PAGE
MAN NO.
CARMEL P 33204 215-0912CC 10/22/15 Net 30 10/22/15 1
ITEM NO. QUANTITY DESCRIPTION UNIT PRICE EXTENDED PRICE
ITEMS ARE NON-TAXABL
1 (1) LOT OF CORNER GUARDS BY
PAWLING 460.00 460.00
SALES AMOUNT 460.00
TOTAL $460.00
@5WGUARD. LITHO USA 08-12 L06SF019028M
City
®�° �� �� INDIANA RETAIL TAX EXEMPT PAGE
,Jlr CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 3320
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
'IOI15�095
U.S. spccialtigs Cairmol Police Department
' VENDOR
SHIP Civic Squat*
2205 River Road TO Caffn@l, IN 46032
Louisville, KY 40 (317)571-2599
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY I UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-350.00
1 Each corder guards $400.00 "400.00
Sub Total: $460.00
� 6
6 i rt o i �
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t
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Send Invoice To:
r r t
Carmel Police Department � -----
Attn: Pat Young
3 Civic squam
Cartel, IN 40332- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
icarmel Folios Dept. "'SY,.l.Fju
PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFYTHAT�THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIAT11O0 96FFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
• C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY �a�✓
SHIPPING LABELS. /;,,6hlct of Police
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMEN DATORY.TH ER EOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. A.P.U. COPY-SIGN AND RETURN TO CLERK'S OFFICE
3
2nd
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
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 except _
20
Signature
— - — --- —..�_.-- Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
U.S. Specialties
IN SUM OF$
2205 River Road
Louisville, KY 40206
$460.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
33204 I 54269 I 42-350.00 I $460.00 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
Thursday, ctober 29, 2015
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))
10/22/15 54269 corner guards $460.00
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