252117 12/02/15 a u,.Coq*f
CITY OF CARMEL, INDIANA VENDOR: 367338
ONE CIVIC SQUARE S P TARGETS CHECK AMOUNT: $"""""""717.90*
CARMEL, INDIANA 46032 18525 NW ST HELENS ROAD CHECK NUMBER: 252117
PORTLAND OR 97231 CHECK DATE: 12/02/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239010 32831 717.90 REPLACE AIR MODULES
SPTargets
18525 NW St. Helens Rd.
Portland, OR 97231
(503)621-3017
SPTargets salesCcDsptargets.com
Invoice
Attn: Ms. Patricia Young
City of Carmel Police
31 1 st Ave. NW
Carmel, IN 46032
Reference: CCP-IN-Parts2
Date: Nov. 23, 2015
For the supply of the following materials:
Product/Service Quantity
Replacement/spare air module 2 $350.00 $700.00
SUBTOTAL
Shipping $17.90
TOTAL $717.90
Annette Montgomery York
Vice-President, Project Management
i
INDIANA RETAIL TAX EXEMPT PAGE
City of
CarM' e1 ._.;.. CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT °i
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
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
4=16
�P4 eta Carmel Police Department
VENDOR SHIP 3 CIVIC squ@ro
16626 iW it Ir olons Rd TO Camel, IN 4
Portland, OR 08 9 (W)579
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
IQUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE ' EXTENSION
Account 42-NO.00
1 E@ch ropkeemerrt sir•modules $797.80 $717.0®
Sub Total: $717.00
O u
£0 °
�•q
-4 ° �
00
Send Invoice To: / �!
Carmel Police Department
Attn: Pat Yung
3 Civic Square
Camel, IN 4 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. L�j PAYMENT $717.90
r 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 T TTHERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPR IIdr�sUFFICIENT TO PAY OR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. ®°I,11d Police
•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. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
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 Laid 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))
11/23/15 replacement air modules $717.90
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
SPTargets
IN SUM OF $
18525 NW St Helens Rd
Portland, OR 97231
$717.90
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
32831 42-390.10 $717.90
I hereby certify that the attached invoice(s), or
I
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
Tuesday, November 24, 2015
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund