326330 06/14/18 J�/ CITY OF CARMEL, INDIANA VENDOR: 361470
` `� ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $*****1,092.50*
•i�. ,a; CARMEL, INDIANA 46032 305 LAKE ROAD CHECK NUMBER: 326330
++i__.._.: MEDINA OH 44256 CHECK DATE: 06/14/18
<roN co'
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
852 5023990 101678 0000343538 1,092.50 BOOSTER SEATS
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995)
Vendor# 361470 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
CHILD SOURCE IN SUM OF$ 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
$1,092.50
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
101678 0000343538 50-239.90 $1,092.50 1 hereby certify that the attached invoice(s),or 5/29/18 0000343538 car seats $1,092.50
1110 852 1110 852
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,June 4,2018
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
120
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
MDISTRIBUTING ERCURIC Invoice
305 Lake Road,Medina,OH 44256
Ph:330.723.4739 Fax:330.721.6799 Invoice Number: 0000343538
REMITTANCE ADDRESS:
WESTERN RESERVE DISTRIBUTING,INC. Invoice Date: 5/29/2018
dba MERCURY DISTRIBUTING or CHILD SOURCE
305 LAKE ROAD Invoice Due Date: 6/28/2018
MEDINA,OH 44256
Customer: CARMPD
Tax ID#82-0563593 Sales Order: 0000179613
Sold To Ship To
CARMEL POLICE DEPARTMENT,CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 W. 146TH ST-SUITE B
ATTN: ANN GALLAGHER ANN GALLAGHER
CARMEL,IN 46032-2584 USA Carmel,IN 46032 USA
Customer P.O. Ship Via, F.O.B Terms
101678 UPS GFP ORIGIN Net 30 Days
Item Description_ Qty Shipped _ Unit Price Amount t
IC201 CHZ OnBoard 35(4-35 lbs)with adjustable base and up front 4 $78.0000 $312.00
adjust
3472198 SONUS CONVERTIBLE SEAT 2PK 4 $57.7500 $231.00
3102198 MAESTRO 50 COMBINATION BOOSTER SEAT 4 $58.3000 $233.20
(20-1001bs)
3431198 Chase No Harness 40-110 lbs Booster Seat,FSM 2 pack 6 $26.9500 $ 161.70
93-299FSM BACKLESS SHIELDLESS BOOSTER(4 PER PACK) 4 $ 14.9000 $59.60
----
———— LAST ITEM ----- ----- --------
Tracking Numbers: 1 ZA7T6670395461956, 1 ZA7T6670396065418, 1 ZA7T6670396880368, 1 ZA7T6670397050315,
Subtotal 997.50
Freight 95.00
Sales Tax 0.00
Discount 0.00
Payment/Credit Amount 0.00
Balance Due 1,092.50