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Home My WebLink About257439 04/12/16 1 1�""A'�l CITY OF CARMEL, INDIANA VENDOR: 361470 ® \\. CHECK AMOUNT: S•'•"'1,593.35' ONE CIVIC SQUARE CHILD SOURCE s;. dao CARMEL, INDIANA 46032 305 LAKE ROAD CHECK NUMBER: 257439 9.y��ioN�� MEDINA OH 44256 CHECK DATE: 04/12/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 900 4359005 33701 0000281166 707.95 BOOSTERS AND CARSEATS 900 4359005 33716 0000281167 885.40 BOOSTER ONBOARD CARSE VOUCHER NO. WARRANT NO. CHILD SOURCE ALLOWED 20 305 LAKE ROAD IN SUM OF$ MEDINA, OH 44256 $885.40 ON ACCOUNT OF APPROPRIATION FOR Carmel Police PO#/Dept. INVOICE NO. T#/Fund AMOUNT Board Members 33716 000028116743-590.05 $885.40 I hereby certify that the attached invoice(s), or 1110 I I 900 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 Monday, April 04, 2016 Cost distribution ledger classification if claim paid motor vehicle highway fund MERCURY Invoice DISTRIBUTING 305 Lake Road,Medina,OH 44256 Ph:330.723.4739 Fax:330.721.6799 Invoice Number: 0000281167 REMITTANCE ADDRESS: Invoice Date: 3/28/2016 WESTERN RESERVE DISTRIBUTING,INC. dba MERCURY DISTRIBUTING or CHILD SOURCE 4/27/2016 305 LAKE RD Invoice Due Date: MEDINA,OH 44256 Customer: CARMPD Tax ID#82-0563593 Sales Order: 0000153157 Sold To Ship To CARMEL POLICE DEPARTMENT,CITY TRINITY HEALTH 3 CIVIC SQUARE 1045 W 146TH STREET CARMEL,IN 46032-2584 USA SUITE B Carmel,IN 46032 USA — Customer-P:O.-= -Ship 33716 UPS ORIGIN Net 30 Days Item Description QtyShipped Unit Price Amount IC201CHZ OnBoard 35 (4-35 lbs)with adjustable base and up 4 $ 84.0000 $ 336.00 front adjust 3702098 TITAN 5 CARSEAT 50#2PK 4 $ 57.7500 $ 231.00 3062198 Chase Factory Select Harnessed Booster Car Seat 2 4 $ 47.1000 $ 188.40 pack --------------------------------------------------------------------------------. LAST ITEM --------------------------------------------------------------------------------- Tracking Numbers: 1ZA7T6670395276782, 1ZA7T6670396743319, 1ZA7T6670396873367, 1ZA7T6670397604922, 1ZA7T66 Subtotal 755.40 Freight 130.00 Sales Tax 0.00 Discount 0.00 PLEASE NOTE NEW REMITTANCE Pavment/CreditAmount 0.00 ADDRESS ABOVE 1 alanc-e_Dud 885.40 VOUCHER NO. WARRANT NO. ALLOWED 20 CHILD SOURCE 305 LAKE ROAD IN SUM OF$ MEDINA, OH 44256 $707.95 ON ACCOUNT OF APPROPRIATION FOR Carmel Police C:--\"a"3 k IfPO#/Dept. INVOICE NO. I ACCT#/Fund AMOUNT Board Members 1�c3370 0000281166 I 43-590.05 I $707.95 1 hereby certify that the attached invoice(s), or 1110 900 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 Monday, April 04, 2016 Cost distribution ledger classification if claim paid motor vehicle highway fund MERCURY Invoice DISTRIBUTING 305 Lake Road,Medina,OH 44256 Ph:330.723.4739 Fax:330.721.6799 Invoice Number: 0000281166 REMITTANCE ADDRESS: Invoice Date: 3/28/2016 WESTERN RESERVE DISTRIBUTING,INC. dba MERCURY DISTRIBUTING or CHILD SOURCE 305 LAKE RD Invoice Due Date: 4/27/2016 MEDINA,OH 44256 Customer: CARMPD Tax ID#82-0563593 Sales Order: 0000152493 Sold To Ship To CARMEL POLICE DEPARTMENT,CITY TRINITY HEALTH 3 CIVIC SQUARE 1045 W 146TH STREET CARMEL,IN 46032-2584 USA SUITE B Carmel,IN 46032 USA ..Customer-P:0. __��_ _ _ _ �.�.._=Ship-Via�_� _.. .;: .., _-_:- ;��-� =.F.OB=-- - _ - -`:Terms ----->�-�--- 33701 UPS ORIGIN Net 30 Days Item Description Qty Shipped Unit Price` Amount IC201CHZ OnBoard 35(4-35 lbs)with adjustable base and up 2 $ 84.0000 $ 168.00 front adjust 3702098 TITAN 5 CARSEAT 50#2PK 4 $ 57.7500 $ 231.00 93-299FSM BACKLESS SHIELDLESS BOOSTER(4 PER 4 $ 14.9000 $ 59.60 PACK) 3062198 Chase Factory Select Harnessed Booster Car Seat 2 2 $ 47.1000 $ 94.20 pack 3431198 Chase No Harness 40-110 lbs(18-49,8kg) 2 $ 26.9500 $ 53.90 Booster Car Seat,Factory Select 2 pack --------------------------------------------------------------------------------. LAST ITEM --------------------------------------------------------------------------------- Tracking Numbers: 1ZA7T6670395468262, 1ZA7T6670395605649, 1ZA7T6670395798870, 1ZA7T6670396107686, 1ZA7T66 Subtotal 606.70 Freight 101.25 Sales Tax 0.00 Discount 0.00 PLEASE NOTE NEW,REMITTANCE , Pavment/CreditAmount 0.00 ADDRESS ABOVE Bal=ante D_ue 707.95 INDIANA RETAIL TAX EXEMPT Page 1 of 1. CERTIFICATE'NO.003120155 002 0 PURCHASE ORDER NUMBER o. f C ® �:JL.Jl me e FEDERAL EXCISE TAX EXEMPT 3370T ONE CIVIC.SQUARE 35-60009.72 THIS NUMBER MUST APPEAR ON INVOICES,AIP 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 2/23/2016 361470 cliiLD:souRCE TRINITY CLINIC VENDOR 308 LAKE ROAD SH/P 1 045 W 146th STREET To SUITE B MED.INA; ON 44256 . CARMEL,, IN 46032 CONFIRMATION BLANKET "CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASUREDESCRI.P.TION UNIT PRICE EXTENSION-: Department: 1110 Account:. 436,596.05 =Granf-Fund�� 4 Each 93-299.FSM backless shieldless..booster4 pk $14.90 $59.60 2.Each 3062198:'. : Chase.factory:select harnessed booster 2 pk $47.10 :. $94.20 2. Each,3431198, Chase no harness 40=110lbs,booster 2pk $26:95 $53:90 -2 .Each:IC201CHZ. OnBoard'35(4-35lbs)with,adjustable.base':: .. $84.00:;: $168:00 1 :Each ". '. . • shipping.charges. $101.25_ $101.25:. .. . 4_ Each 3702098 Titan 5 carseat 50#2pk'_ . $57.15 $231.00. Sub Total $707:95 In� Send Invoice To: Carmel Police 3 Civic Square Carmel;IN 46032- . . PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT: , PAYMENT $707:9:5 SHIPPING INSTRUCTION '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 APPROPRIATION SUfFICIENT TO PAY,FOR THE ABOVE ORDER. 'PURCHASE ORDER NUMBER MUST APPEAR ON ALL,SHIPPING.LABS 'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 194 AND ACTS AMENDATORY THEREOF.AND SUPPLEMENT THERETO. ORDERED BY. TITLE CONTROL NO.. 3370 CLERK-TREASURER