182269 02/17/2010 CITY OF CARMEL, INDIANA VENDOR: 025400 Page 1 of 1
ONE CIVIC SQUARE BESTEST, INC CHECK AMOUNT: $420.00
CARMEL, INDIANA 46032 812 S MAIN ST
PO BOX 405 CHECK NUMBER: 182269
CASEYVILLE IL 62232
CHECK DATE: 2/1712010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRI
1110 4239099 21345 2100073 420.00 PBT MOUTHPIECES
gesTesT, Inc. INVOICE
812 So. Main St., P.O. Box 405
Caseyville, IL 62232 DATE INVOICE NO.
618 -397 -3177 800 248 -3244
FAX 618 -397 -3177 2/9/2010 2100073
BILL. TO SHIP TO
Account #1122500 City of Carmel Police Department
City of Carmel Police Department Attn: Robert Robinson
Attn: Teresa Anderson 3 Civic Square
3 Civic Square Carmel, IN 46032
Carmel, IN 46032
P.O. NO. TERMS DUE DATE SHIP DATE SHIP VIA FOB
21345 Net 30 3/11/2010 2/8/2010 UPS Destination
ITEM DESCRIPTION QTY RATE AMOUNT
PBT -W WHISTLER Mouthpieces 2,000 0.21 420.00
Thank you for choosing BesTesT FEIN 37- 1211084 Total
E- mail sales @bestest.biz Web www.bestest.biz $420.00
INDIANA RETAIL TAX EXEMPT PAGE
Ci o I' Carmel CERTIFICATE NO. 003120155 002 0 Ji PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT 21345
35- 60000972
10NE 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
February 5, 2 10 PBT mouthpieces
VENDOR BesTest, In c. SHIP City o f Carmel P Depar:ltent
P.O. Box 405 TO 3 Civic Square
Caseyville, IL 62232 Carmel, IN 46032
ATTN: Holly Gilkeson ATTN: Robert Blobi.naeun
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
2,000 PBT Whistler mouthpieces .21 424.00
a
City of Carmel Poi` par
Send Invoice To: ATTN: Teresa Anderso
t li
3 Civic Square
Carmel, IN 46032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
1110 390 -99 -other miscellaneaiS
PAYMENT
j` A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
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
SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUSTAPPEAR ON ALL L
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of POlice
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO. A3. COPY SIGN AND RETURN TO CLERIC'S OFFICE
VOUCHER NO. WARRANT NO.__—
ALLOWED 20
W THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or fNVO10E NO. ACCT #MILE 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 j
Signature
Title
I
Cost distribution ledger classification if
claim paid motor vehicle highway fund
I
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
BesTest, Inc. Purchase Order No. 21345F
812 South Main Street Terms
P.O. Box 405
Caseyville, IL 62232 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
2/9/10 2100073 payment for mouthpieces 420.00
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
B:'.sTest, Inc. IN SUM OF
P10. Box 405
Caseyville, IL 62232
420.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #(TITLE AMOUNT
DEPT_ a I hereby certify that the attached invoice(s), or
21345F 2100073 390 -99 420.00 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
February 12 20 10
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund