HomeMy WebLinkAbout305108 11/14/16 0<`��.Feq�i CITY OF CARMEL, INDIANA VENDOR: 361470
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ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $**"'1,060.30'
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CARMEL, INDIANA 46032 305 LAKE ROAD CHECK NUMBER: 305108
'�;iTON. MEDINA OH 44256 CHECK DATE: 11/14/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
900 4359005 34389 0000302567 1,060.30 BOOSTER CARSEAT
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
CHILD SOURCE ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
305 LAKE ROAD IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
MED I NA, OH 44256 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$1,060.30 Payee
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Carmel Police Terms
Date Due
PO#, _ ACCT# DATE INVOICE# DESCRIPTION
—
DEPTINVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
-"34389 0000302567 43-590.05 $1,060.30 1 hereby certify that the attached invoice(s),or 2/16/00 0000302567 carseats $1,060.30
1110 900 Prior Year 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
Tuesday, November 08, 2016
Tim Green
Chief of Police
I 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
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
—q0VMERCURY Invoice
DISTRIBUTING
305 Lake Road,Medina,OH 44256
Ph:330.723.4739 Fax:330.721.6799 Invoice Number: 0000302567
REMITTANCE ADDRESS: Invoice Date: 11/2/2016
WESTERN RESERVE DISTRIBUTING,INC.
dba MERCURY DISTRIBUTING or CHILD SOURCE 12/2/2016
305 LAKE RD Invoice Due Date:
MEDINA,OH 44256 Customer: CARMPD
Tax ID#82-0563593 Sales Order: 0000163394
Shi
Sold To — �— p To - — —
CARMEL POLICE DEPARTMENT,CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 W 136TH STREET SUITE B
ATTN: ANN GALLAGHER ATTN: ANN GALLAGHER 317-571-2720
CARMEL,IN 46032-2584 USA Carmel, IN 46032 USA
,.
C--CustomerP.O.-----
34389 LTL-OLD DOM ORIGIN Net 30 Days
__ Item _ __Description — QtXShipped 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 509 2PK 4 $ 57.7500 $ 231.00
3102198 MAESTRO 50 COMBINATION BOOSTER SEAT 2 $ 58.3000 $ 116.60
(20-1001bs)
3431198 Chase No Harness 40-110 lbs Booster Seat,FSM 2 2 $ 26.9500 $ 53.90
pack
93-299FSM BACKLESS SHIELDLESS BOOSTER(4 PER 4 $ 14.9000 $ 59.60
PACK)
--------------------------------------------------------------------------------- LAST ITEM ---------------------------------------------------------------------------------
Tracking Numbers: 32502401451
Subtotal 797.10
DEL APPT REQ 317-571-2720,L/G&INSIDE Freight 263.20
Sales Tax 0.00
Discount 0.00
PLEASE NOTE NEW REMITTANCE Payment/CreditAmount 0.00
ADDRESS ABOVE C: - --_Balance Due 1,060.30