319576 12/12/17 CITY OF CARMEL, INDIANA VENDOR: 361470
d ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $*****1,647.80*
aQ CARMEL, INDIANA 46032 Moi A OH AD CHECK NUMBER: 319576
CHECK DATE: 12/12/17
DEPARTMENT ACCOUNT PO NUMBER. INVOICE NUMBER_ AMOUNT DESCRIPTION
900 4359005 100914 0000332001 1,647.80 CHILD BOOSTERS
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 361470 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
CHILD SOURCE IN SUM OF$ CITY OF CARMEL
305 LAKE ROAD 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.
MEDINA, OH 44256
Payee
$1,647.80
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Carmel Police Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
100914 0000332001 43-590.05 $1,647.80 1 hereby certify that the attached invoice(s),or 12/6/17 0000332001 Car Seats $1,647.80
1110 900 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, December 12,2017
w
Jim Barlow
Chief
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
MERCURY Invoice
DISTRIBUTING
305 Lake Road,Medina,OH 44256
Ph:330.723.4739 Fax:330.721.6799 Invoice Number: 0000332001
REMITTANCE ADDRESS: Invoice Date: 11/27/2017
WESTERN RESERVE DISTRIBUTING,INC.
dba MERCURY DISTRIBUTING or CHILD SOURCE
305 LAKE RD Invoice Due Date: 12/27/2017
MEDINA,OH 44256 Customer: CARMPD
Tax ID#82-0563593 Sales Order: 0000175493
72
CARMEL POLICE DEPARTMENT,CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 W. 145TH ST-SUITE B
ATTN: ANN GALLAGHER ATTN:ANN GALLAGHER
CARMEL,IN 46032-2584 USA Carmel,IN 46032 USA
100914 UPS GFP ORIGIN Net 30 Days
IC201CHZ OnBoard 35(4-35 lbs)with adjustable base and up 7 $ 84.0000 $ 588.00
front adjust
3472198 SONUS CONVERTIBLE SEAT 2PK 4 $ 57.7500 $ 231.00
3102198 MAESTRO 50 COMBINATION BOOSTER SEAT 8 $ 58.3000 $ 466.40
(20-1001bs)
3431198 Chase No Harness 40-110 lbs Booster Seat,FSM 2 4 $ 26.9500 $ 107.80
pack
93-299FSM BACKLESS SHIELDLESS BOOSTER(4 PER 4 $ 14.9000 $ 59.60
PACK)
--------------------------------------------------------------------------------- LAST ITEM ---------------------------------------------------------------------------------
Tracking Numbers: 1ZA7T6670390166098, 1ZA7T6670390383611, 1ZA7T6670391423629, 1ZA7T6670391687729, 1ZA7T66'
Subtotal 1,452.80
Freight 195.00
Sales Tax 0.00
Discount 0.00
PLEASEIDT'ENEW'REMITTANCE}
N
Payment/Credit Amount
0.00, R
1,647.80