181560 01/20/2010 CITY OF CARMEL, INDIANA VENDOR: 00351072 Page 1 of 1
ONE CIVIC SQUARE GLOCK INC
1 .t CARMEL, INDIANA 46032 PO BOX ass CHECK AMOUNT: $147.00
4 SMYRNA GA 30051 CHECK NUMBER: 181560
CHECK DATE: 1120/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 R4239010 21297 528828 147.00 PARTS
GLOC Inc. USA [I ocK
PERFECTION
GLOCK, Inc., Post Office Box 369 Tel. (770) 432 -1202
Smyrna, Georgia 30081 USA Fax (770) 433 -8719
Customer 22364
FFL No.
Carmel Metro Police Department Tax Number
Attn :Lt. Dwight Frost Del. Terms CIF destination
#3 Civic Square Del. Date 01/04/2010
Carmel, IN Forw. Agent: Fedex 2Day(D &I)
46032 Customer PO: 21297
Attn Lt. Dwight Frost
FFL- No.Info: Law Enforcement Agency
INVOICE
Invoice No. Date Order Number Contact Page
SLS/ 528828 01/04/2010 427998 176 1
Pos Deliv Item Number Price /Unit Discount Total Price
No. City. Item Description USD
5 1 NR17G24 32.00/pc 32.00
Sight Rear 6.5 GLOCK NS (Green
10 1 NF17G24 25.00 /pc 25.00
Sight Front GLOCK NS(Screw on)
15 1 SP05946 f.o.c.
Sight Front Screw
20 2 GT03374 5.00 /pc 10.00
Disassembly Tool 2.5mn
FFL 1 -58- 067 -08 -2M -21808 td4404.cary 67.00
FEDERAL TAX PAYER ID 58- 1652822
GA STATE SALES TAX #:033 -24- 33264 -2
L 0 C K, Inc. USA OCK
PERFECTION
CLOCK, Inc., Post Office Box 369 Tel. (770) 432 -1202
Smyrna, Georgia 30081 USA Fax (770) 433 -8719
Invoice No. Date Order Number Contact Page
SLS/ 528828 01/04/2010 427998 176 2
Pos Deliv Item Number Price /Unit Discount Total Price
No. Qty. Item Description USD
Carry Forward: 67.00
25 10 SP00420 2.00 /pc 20.00
Trigger Pin
30 5 SP07496 8.00 /pc 40.00
Slide Stop Lever EXTENDED G17
35 5 SP01981 2.00 /pc 10.00
Magazine Catch Extended 9mm,.4
40 1 SHIP 10.00 /pc 10.00
Shipping Handling Charge
Goods Costs Total USD
137.00 10.00 147.00
Payment Net 30 Days
Should there be any discrepancies with your order, please contact customer service immediately.
INDIANA RETAIL TAX EXEMPT
lvs PAGE
O C CERTIFICATE NO. 002 0 1 c6 1
PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT 21297
35- 60000972
30.NE 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 16, 2C09 parts
VENDOR Glock, Inc. SHIP City of Carmm1 Police Department
P.O. Box 369 TO 3 Civic Square
Smyrna,. GA 30081 Carmel, IN 46032
ATTN: Lt. Dwight Frost
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY I UNIT OF MEASURE DESCRIPTION UNIT PRICE I EXTENSION
1 NR17G24 Rear night sight 6.5mm 32.00
1 NF17G21 Front night sight 25.00
2 GT00374 Glock disassembly tool 5.00 10.00
10 SP00420 Trigger pin .2.00 x0.00
5 SP07496 Slide stop lever extend._,.wth spring 8.00 40.00
5 SP01981 Magazine catch e ed c l m 2..00 1��.00
shipping 10.00
4 c\p e
UH ‘N'::-N T
1 4 1.-
4 0
ct i k, ki
m
M
111*. .„.1 1 1 4 l' 9 ,t i
Nt A li. q 7' "4 0 f
City of Carmel Pol c
Send Invoice To.
ATTN: Teresa Anderson'
3 Civ i Square
Canal., IN 46032 DD
l PLEASE INVOICE IN DUPLICATE 0:13-6-
DEPARTMENT ACCOUNT PROJECT 1 I PROJECT ACCOUNT AMOUNT
1110 390 -10 ammo and accessories.
PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
1 VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS i 1 HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID. hi 4 D J/
/3 °r'idr /l •�-�A!
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY �..t
r 0 {f c'. i' D 7 .iie
PURCHASE ORDER NUMBER MUST APPEAR ON ALL f
SHIPPING LABELS. Chief of Police fl
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETOO.
1 DOCUMENT CONTROL NO. 2A, 7 CLERK-TREASURER
.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VGUCHER 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 Slate 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
Glock, Inc. Purchase Order No. 21297RF
P.O. Box 369 Terms
Smyrna, GA 30081 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1/4110 528828 payment for parts 147.00
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOU PHER NO. WARRANT NO.
ALLOWED 20
Glock, Inc. IN SUM OF
P.O. Box 369
Smyrna, GA 30081
147.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or
DEPT. INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
21297RF 528828 390 -10 147.00 bills) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
January 13 20 10
b
Signature
Chief of POlice
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund