181554 01/20/2010 CITY OF CARMEL, INDIANA VENDOR: 105300 Page 1 of 1
I 4 t ONE CIVIC SQUARE G.A. THOMPSON, INC CHECK AMOUNT: $2,038.35
s CARMEL INDIANA 46032 PO BOX 720254
a DALLAS TX 75372 CHECK NUMBER: 181554
CHECK DATE: 1/20/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4342100 79763 133.35 POSTAGE
1110 R4230000 21308 79763 1,905.00 WARNING /TICKET BOOKS
G.A. THOMPSON CO. Invoice
PO BOX 720254 Date Invoice
DALLAS TX 75372
214-827-1688 12/31/2009 79763
TAX ID 75- 1540137
Bill To Ship To
CARMEL POLICE DEPT CARMEL POLICE DEPT
3 CIVIC SQUARE 3 CIVIC SQUARE
CARMEL IN 46032 CARMEL IN 46032
317 571 2548 fax 2512
1
P.O. Number Terms Rep Ship Via F.O.B. Project
Net 30 12/31/2009
Quantity Item Code Description Price Each Amount
5,000 IN -17 -4 INDIANA (4 PART) UNIFORM TRAFFIC TICKET 0.21 1,050.00
no changes, continue from last
7,500 CUSTOM 15 -2c 0.114 855.00
no changes, continue from last
133.35 FREIGHT Shipping and Handling 1.00 133.35
We Accept Visa, Master Total $2,038.35
Card and American Express
City INDIANA RETAIL TAX EXEMPT PAGE
C.Irrnel. CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 71 1(1R
3)OUE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
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
December 22, 2,)09 warning ticket books
VENDOR G.A. Thompson SHIP City of Carmel Police Department
P.O. Box 720254 TO 3 Clinic Square
Dallas, TX 75372 Carmel, IN 46032
ATTN: Robert Robinson
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
5,000 IN -17-4 Indiana (d part) Unifo Traffic tickets .21 1,050.00
7,500 Custom warning tickets 15 -2c .114 855.00
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Send Invoice To: City of Carmel Po e
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merit
ATTN: Teresa Anderso_-
3 Civic Square
Carmel, IN 46032
PLEASE INVOICE IN DUPLICATE 1,905.00
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 300 9- official forms A 4AYMENT
6 A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.0
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER
SHIP REPAID
C.O -D. SHIPMENTS CANNOT BE ACCEPTED. /1/14-"*'---..---- PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY I�
IY
SHIPPING LABELS of THIS ORDER ISSUED EN COMPLIANCE WITH CHAPTER 99 ACTS 1945 TITLE Assistant Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO
8 CLERK TREASURER
A DOCUMENT CONTROL NO. ..i. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO, WARRANT NO.
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT I hereby certify that the attached invoice(s), or
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
20
Signature
Title
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
,GA Thompson Co. Purchase Order No. 21308RF
P.O. Box 720254 Terms
Dallas, TX 75372 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/31/09 79763 payment for citation and warning ticekts 2,038.35
Total
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
Clerk- Treasurer
V4IUCHER NO. WARRANT NO.
ALLOWED 20
G.A. Thompson Co.
IN SUM OF
P.O. Box 720254
Dallas, TX 75372
2,038.35
ON ACCOUNT OF APPROPRIATION FOR
police genera flund
Board Members
NO. #/TITLE AMOUNT hereby certify invoice( s), DEPT PO# or INVOICE NO ACCT I hereb certi that the attached invoices or
21308RF 79763 300 1,905.00 bill(s) is (are) true and correct and that the
1110 79763 421 133.35 materials or services itemized thereon for
which charge is made were ordered and
received except
January 13 20 10
igie-14A-A4 Z
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund