181648 01/20/2010 ^a CITY OF CARMEL, INDIANA VENDOR: 363645 Page 1 of 1
ONE CIVIC SQUARE RIMAGE CORPORATION
F 7 725 WASHINGTON AVE SOUTH CHECK AMOUNT: $1,959.39
CARMEL, INDIANA 46032 ATTN:BRIAN KELLY CHECK NUMBER: 181648
MINNEAPOLIS MN 55439
CHECK DATE: 1/20/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 R4230200 21281 90059744 1,959.39 OFFICE SUPPLIES
Page 1 of 1
Phone: (952)944-8144
01/06/2010 08:38:00
Fax: (952)944 -7808
R1 M AG E" Internet: www.rimage.com
Invoice
Sold-To-Party Information
CITY OF CARMEL POLICE DEPT. Invoice Number /Date 90059744 01/05/2010
3 CIVIC SQUARE Delivery Number /Date 80085872 01/05/2010
CARMEL IN 46032 Sales Order Number /Date 10029244 01/05/2010
USA PO Number 21 281
PO Date 01/05/2010
Customer No. 120998
Ship ;To Party Invoice Amt 1,959.39 USD
CARMEL CLAY COMMUNICATIONS CNTR. Term of Payment Net due in 30 days
31 1ST AVE. NW Incoterm FOB DESTINATION
CARMEL IN 46032 Gross Weight 59.100 LB
USA Volume 1.790 HL
Bill of Lading 1 Z5W19X80342738502
Rimage Contact Tracey Dietsch
Customer Contact: MICHAEL FOGARTY
ATTN. TODD LUCKOSKI
Item Material /Description Quantity Unit Price Value
10 210843 -003 1 EA 727.01 727.01
MEDIA KIT EV DVD CMY 1000 16X
20 203638 -001 2 EA 110.80 221.60
RIBBON, EVEREST CMY REV2
EVEREST CMY RIBBON ICY) REV 2
40 210555 -001 2 EA 18.39 36.78
PRINTHEAD CLEANING KIT,CD
50 2001393 100 EA 9.74 974.00
BDR 6X SL 25GB WHT EV
_Subtotal. 1. 959._39_,
Drop Ship 0.00
Freight 0.00
Tax 0.00
Total Invoice Amount 1,959.39
Wells Fargo Bank, N.A. Please Remit Payment to:
Minneapolis, MN Account 4100163674 Rimage Corporation
ABA Routing 121000248 S.W.I.F.T. WFBIUS6S NW5255 PO Box 1450
Federal ID 41- 1577970 Minneapolis, MN 55485 -5255
DUNS# 15- 177 -2530
Thank you for your business.
Freight Charges include taxes, duties and brokerage fees which are not refundable in the event of a return. Rimage
reserves the right to send a supplemental invoice for additional freight expenses incurred after the actual ship date.
t., ity Ot 1., ar el IRTI A E TAIL 03 11 0155 0 1
CERTIFICATE NO. 003120155 002 0
PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 i
3X EXCIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, AEI
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS
SHIPPING LABELS AND ANY CORRESPONDENCE
=ORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
RCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
ecember 8, 2009 office supplies
rENDOR Rimage Corporation SHIP Carmel Clay Communications Center
7725 Washington Avenue South TO 31 1st Avenue NW
Minneapolis, MN 55439 Carmel, IN 46032
ATTN: Brian Kelly ATTN: Todd Luckoski
■NFIAMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE N DESCRIPTION I UNIT PRICE EXTENSION
GSA Schedule COntract #GS- 35F -0537P
1 Rimage Media Kit DVD 727.01
2 Rimage Everest III CMY Ribbon 110.80 221.60
1 Rimage Everest III Transfer Roll 71.08
2 Rimage Everest Illg-Printhead,/Cleaning kit 18.39 36.78
100 Blu -Ray Media f 7 media only Evexest 9.74 974.00
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City of Carmel Police Department, v, Send Invoice To: ATTN: Teresa Anderson� II ,I
3 Civic Square
Carmel, IN 46032
PLEASE INVOICE IN DUPLICATE
2,030.47
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
1110 302 office supplies P YMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE PO.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
4 1i L_
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOS THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. i
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY 1111 i /Ia f
SHIPPING LABELS
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief o f Po lice
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO. 2 1. 2 8 1 VENDOR COPY
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
Rimage Corporation Purchase Order No. 21281RP
NW5255 P.O. BOx 1450 Terms
Minneapolis, MN 55485 -5255 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1/6/10 90059744 payment for office supplies 1,959.39
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Rimage Corporation IN SUM OF
NW5255 P.O. Box 1450
Minneapolis, MN 55485 -5255
1,959.39
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
Pop or INVOICE NO. ACCT #/TITLE AMOUNT hereby certify
oEPr. I hereb certif that the attached invoices or
21281RP 90059744 302 1,959.39 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
January 13 20 10
11
Signature
Chie.f of_ Poi ice
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund