HomeMy WebLinkAbout256881 03/31/16 1 yf„CggM
/ �� CITY OF CARMEL, INDIANA VENDOR: 361470
® ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $*******960.00*
=Q CARMEL, INDIANA 46032 305 LAKE ROAD CHECK NUMBER: 256881
r�.� ,.'. MEDINA OH 44256 CHECK DATE: 03/31/16
lTON 4,�.
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
852 5023990 33722 0000279780 960.00 CHICO KEYFIT 30
VOUCHER NO. WARRANT NO.
CHILD SOURCE ALLOWED 20
305 LAKE ROAD IN SUM OF$
MEDINA, OH 44256
$960.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police
PO#/Dept. INVOICE NO. ACCT#/Fund AMOUNT Board Member:
33722 0000279780 50-239.90 $69.00 1 hereby certify that the attached invoice(s), or
1110 852
33722 0000279780 50-239.90 $891.00 bill(s) is (are)true and correct and that the
1110 852 materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, March 28, 2016
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 Date Invoice# Description Amount
Dept. Fund# (or note attached invoice(s)or bill(s))
03/28/16 0000279780 Shipping $69.00
1110 852
03/28/16 0000279780 Car Seats $891.00
1110 852
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
7-0VMERCURY Invoice
DISTRIBUTING
305 Lake Road,Medina,OH 44256
Ph:330.723.4739 Fax:330.721.6799 Invoice Number: 0000279780
REMITTANCE ADDRESS:
WESTERN RESERVE DISTRIBUTING,INC. Invoice Date: 3/15/2016
dba MERCURY DISTRIBUTING or CHILD SOURCE 4/14/2016
305 LAKE RD Invoice Due Date:
MEDINA,OH 44256 Customer: CARMPD
Tax ID#82-0563593 Sales Order: 0000153402
:Sold To -Ship Toro: s j >
,r
CARMEL POLICE DEPARTMENT,CITY CARMEL POLICE DEPT
3 CIVIC SQUARE 3 CIVIC SQUARE
CARMEL,IN 46032-2584 USA PO 33722
Carmel,IN 46032 USA
` OTI10r -O �r j" m s h1p�Via:_- 3.y mtt 3.F.O.BaYQddadTCI � k! w
33722 UPS ORIGIN Net 30 Days
, Item :. Descn tion; Qty Ship ed ` Unit Fnce Aino_unt
61472.19 CHICCO-KeyFit 30 Infant Car Seat/Base- 6 $ 148.5000 $ 891.00
PAPYRUS
--------------------------------------------------------------------------------- LAST ITEM ---------------------------------------------------------------------------------
Tracking Numbers: 1ZA7T6670390580818, 1ZA7T6670391185637, 1ZA7T6670392611192, 1ZA7T6670393811241, 1ZA7T667
Subtotal 891.00
Freight 69.00
Sales Tax 0.00
Discount 0.00
PLEASE NOTE N_EW=REMITTANCE Payment/CreditAmount 0.00
`ADD -89S ABOVE' Balance_Due 960.00
v INDIANA RETAIL TAX EXEMPT Page 1 of 1
}� CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
® arm .��
FEDERAL EXCISE TAX EXEMPT 83722, .
ONE CIVIC SQUARE 35=6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
CARMEL,JND.IANA 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 -
3/11%2016 361470
CHILD.SOURCE Carmel Police, .
VENDOR 305-LAKE ROAD SHIP 3 Civic Square
TO Carmel, IN 46032-
MEDINA,OH 44256-
CONFIRMATION
4256-CONFIRMATION BLANKET CONTRACT. PAYMENTTERMS FREIGHT
QUANTITY. UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION.
Department: 1110 Account:, 120-852.00 and„;852�Glft F ntl
6 Each ." CHICCO-Keyfit 30 infance.ca_r seat/base $148.50. $891.00
1.:Each shipping charges $69.00 $69.00:
:Sub Total. . $960:00
Send 1nvoide .To: '
Carmel Police
3 Civic Square"
Carmel, IN 46032-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT '.. ACCOUNT PROJECT PROJECT ACCOUNT- AMOUNT: :
C� PAYMENT $960.0.0 .
SHIPPING INSTRUCTIONS 'AIP 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
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
'C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRI TI N SUFFICIENT TO PAY FOR THE ABOVE ORDER.
'PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABE
'THIS ORDERISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 194ZaA_
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY
TITLE
CONTROL NO. 33722 CLERK-TREASURER