182069 02/03/2010 /,'57. 77, 7;; CITY OF CARMEL, INDIANA VENDOR. 363645 Page 1 of 1
1.■iit.1 ONE CIVIC SQUARE RIMAGE CORPORATION
1 c CARMEL, INDIANA 46032 NW5255 CHECK AMOUNT: $71.08
'''-‘,42„.:,„.-„,6c, PO BOX 1450 CHECK NUMBER: 182069
MINNEAPOLIS MN 55485 -5255
CHECK DATE: 2/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 R4230200 21281 90060104 71.08 OFFICE SUPPLIES
Page 1 of 1
4crW Phone: (952)944 -8144 01/16/2010 02:01:01
Fax: (952)944 -7808
RI M A G E TM Internet: www.rimage.com
Invoice
Sold Information
CITY OF CARMEL POLICE DEPT. Invoice Number /Date 90060104 01/15/2010
3 CIVIC SQUARE Delivery Number /Date 80086505 01/15/2010
CARMEL IN 46032 Sales Order Number /Date 10029244 01/05/2010
USA PO Number 21281
PO Date 01/05/2010
Customer No. 120998
Ship-To-Party Invoice Amt 71.08 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 1.900 LB
USA Volume 10 GAL
Bill of Lading 1Z5W19X80346302073
Rimage Contact Tr acey Die[sch
Customer Contact: MICHAEL FOGARTY
ATTN. TODD LUCKOSKI
Item Material /Description Quantity Unit Price Value
30 203384 -001 1 EA 71.08 71.08
RETRANSFER SHEET, 12 MIC
Subtotal 71.08
Drop Ship 0.00
Freight 0.00
Tax 0.00
Total Invoice Amount 71 .08
Wells Fargo Bank, N.A. Please Remit Payment to:
Minneapolis, MN Account 4100163674 Rimage Corporation
ABA Routing4'11000248 S.W.I.F.T. WFBIUS6S NW5255 PO Box 1450
Federal ID if 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.
4 INDIANA RETAIL TAX EXEMPT PAGE
City ®f Carmel CERTIFICATE NO. 003120155 002 0 1 of 1
PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 21 2R 1
3,10LJEKCIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, Ad.
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 8, 20)9 office supplies
VENDOR Rimage Corporation SHIP Carmel Clay Communications Center
7725 Washington AVenue South TO 31 1st Avenue NW
Minneapolis, MN 55439 Caramel, IN 46032
ATTN: Brian Kelly ATTN: TOdd Luckoski
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY ,UNIT OF MEASURE DESCRIPTION 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 I1I Transfex,Rodll 71.08
2 Rimage Everest. I1 {r as ng kit 18.39 36.78✓
100 Blu -Ray Media 46-# q, on y s ompatible 9.74 974.00
s a s V 4
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'Ilk 0 q
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a a e iP erg* \,',:-.9
City of Carmel Pol.. e t :p
Send Invoice To: ATTN: Teresa Anders:
3 Civic Square
Caramel, IN 46032
PLEASE INVOICE IN DUPLICATE 2,030.47
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 302 office supplies PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
r VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
1 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. r 11
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY 1.'L.'( 'Ld1'_ b l 4t l °I�E 1i
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO.
t". A. 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
Rimage Corporation Purchase Order No. 21281RF
NW 5255 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))
1/16/10 90060104 payment for office supplies 71.08
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. t WARRANT NO.
ALLOWED 20
Rimage Corporation IN SUM OF
NW5255
P.O. Box 1450
Minneapolis, MN 55485 -5255
71.08
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
°T INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
21281RF 90060104 302 71 .08 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 27 20 10
*1;144*a 1 /49
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund