Loading...
183860 03/29/2010 CITY OF CARMEL, INDIANA VENDOR: 178620 Page 1 of 9 0 ONE CIVIC SQUARE KUSTOM SIGNALS, INC CARMEL, INDIANA 46032 PO BOX 411882 CHECK AMOUNT: $605.02 ATTN ACCTS REC CHECK NUMBER: 183860 KANSAS CITY MO 64141.1882 CHECK DATE: 3/29/2010 DEPARTMENT ACCOUNT PO NUMBER I NUMBER AMOUNT DESCRIPTION 1110 4350000 21847 412517 200.82 REPAIRS 1110 4350000 21853 412525 143.00 RADAR RECERTIFICATION 1110 4350000 412526 125.00 EQUIPMENT REPAIRS M 1110 4350000 21848 412630 136.20 REPAIRS Invoice Number 412517 Invoice KUSTOM SIGNALS, INC Customer Copy REMIT TO: Invoice Date 03/12/10 A PUBLIC SAFETY EQUIPMENT COMPANY Customer Number 16673 1010 W. Chestnut I P.O. Box 947 KUSTOM SIGNALS, INC. Chanute, KS 66720 -0947 PO BOX 411882 Order Dumber 158188 SR (620) 431 -2700 Fax (620) 431 -2734 KANSAS CITY, MO 64141 -1882 Customer PO 21847 SOLD TO Page 1 of 1 CARMEL POLICE DEPT SHIP TO POLICE DEPT HDQTRS CARMEL POLICE DEPT 3 CIVIC SQUARE POLICE DEPT HDQTRS CARMEL IN 46032 3 CIVIC SQUARE CARMEL IN 46032 Net Due Date 04/11/10 Terms net 30 Shipping UPS 38115 `Q ry y n l� .A llc'#rl `t {y� #aaa.kldWSf §3kT?'i p T8'k m 'am $�`4.nSi�'.[ P rt- Number V DESCRIPTIUNe /Serlfal #r R �ce� 3 rer .w z n a Y n b �a x _a 'tae c. emu': �L7h�ipeti roz@ A u 3 g `ro ..#;wri. «tiaad �k v a g �tPr e P r x 1 064 0068 -OOR PRO- 1000DS Serial Number(s) DSO4594 38115 DSO4594 OW 7 -15 -99 Moving inop; stationary works Jason Ogle 317 733 -4600 FAX 317 733 -6257 jogle @carmel.in.gov 1 888 8888 -38 CS FREIGHTGROUND 11.00 11.00 INBOUND SHIPPING CHARGES 1 155 3015 -06 CABLE POWER PRO -DS 6 FT 46.39 46.39 1 135 0001 -00 RES VAR CLAIREX CL905L 13.98 13.98 1 133- 0155 -01 POT 10K LINEAR MODIFIED 16.95 16.95 1 222 2312 -01 CS RADAR ROAD TEST ASSESSMENT 15 111- 1111 -13 COW Radar Labor tenths of hr 7.50 112.50 OOW Radar Labor tenths of hr DS 04594 COUNTING UNIT ONLY. REPLACED POWER CABLE, (DAMAGED), PHOTO CELL, (INOP) 8 SWITCH, (BROKEN). ROAD TESTED 8 FUNCTION TESTED. REMIT TO: FEDERAL ID'# 43- 1757730 Subtotal 200.82 KUSTOM SIGNALS, INC. Tax 0.00 PO BOX 411882 IIIIIIIIIII� I I I KANSAS CITY, MO 64141 -1882 TOTAL 200.82 WWW.KUSTOMSIGNALS.COM KUSTOM SIGNALS, INC. TERMS AND CONDITIONS 1. APPLICABILITY. Unless otherwise specified CONNECTION WITH THIS PURCHASE ORDER IS in a written bid, quote or contract, the following terms and LIMITED TO THE AMOUNT PAID FOR THE GOODS. conditions shall apply. 9. INDEMNIFICATION. Buyer will indemnify, 2. PRICES AND TAXES. Prices will be Kustom defend and hold Seller harmless from all losses, damages, Signals, Inc.'s (`'Seller prices in effect on the date a liabilities and costs, including attorneys' fees, incurred or purchase order is accepted by Seller, and Seller may change sustained by Seller as a result of any third parry claim made its prices at any time, in its sole discretion. All prices will against Seller, including a claim by a customer of Buyer, be F.O.B. Chanute, Kansas, and net of any duties, sales, use arising from its negligent, reckless, willful, or intentional or similar taxes, fees or assessments, and do not include actions in marketing and reselling the goods. shipping, packaging or any insurance costs, all of which are Buyer's responsibility. 10. EXPORT RULES. Buyer will not ship, transfer or export the goods into any country or use the goods in 3. PAYMENT. Unless otherwise provided on the any manner prohibited by the United. States Export face of the invoice, payment is due net 30 days of invoice Administration Act or any other export laws, restrictions or in US dollars. Partial payments are not permitted unless regulations (collectively the "Export Laws'). In addition, if authorized in writing. Partial payments will be treated as the goods are identified as export controlled items under non payment. Each invoice is independent from shipping the Export Laws, Buyer represents and warrants that Buyer sequence and disputes relating to other invoices. Failure to is not a citizen, or otherwise located within, an embargoed pay an invoice within 30 days will be considered a default. nation (including, without limitation Iran, Iraq, Syria, Sudan, Libya, Cuba, and North Korea) and that .Buyer is 4. DELIVERY AND PERFORMANCE. Delivery not otherwise prohibited under the Export Laws from dates are approximate. Seller disclaims all liability for late receiving the goods. or partial delivery. Seller may deliver in such lots and at such times as is convenient for Seller. 11. MISCELLANEOUS. This purchase order, together with any other written agreement between Buyer 5. LOSS IN TRANSIT. Risk of loss will pass to and Seller, if any: (i) is the exclusive statement of the Buyer upon delivery of the goods to the carrier. In case of parties with respect to the subject matter and supersedes any prior or contemporaneous communications; (ii) may breakage or loss in transit, Buyer will have notation of not be amended except in writing executed by the parties; same made on expense bill before paying freight. Seller and (iii) will be interpreted and enforced in accordance may reject claims for shortages not made within 15 days of with the laws of the State of Kansas, without giving effect Buyer's receipt of the goods. to principles of conflicts of law. This purchase order is: (1) solely for the benefit of the parties, and no provision of 6. TERMINATION, RESTOCKING CHARGES. this purchase order will be deemed to confer upon any Buyer may terminate this purchase order for its other person any remedy, claim, liability, reimbursement, convenience, in whole or in part, by written, faxed or cause of action or other right. Each party consents to the telegraphic notice at any time. If Buyer terminates this exclusive personal jurisdiction of the state and federal purchase order for convenience, Buyer will be liable to courts located in the State of Kansas for purposes of any Seller for Seller's reasonable costs incurred in the suit, action or other proceeding arising out of this performance of this purchase order that Seller cannot Agreement, waives any argument that venue in any such mitigate. Unless otherwise agreed upon in advance in forum is not convenient and agrees that the venue of any writing by Seller, Seller may charge Buyer a 25% litigation initiated by either of them in connection with this restocking fee if: (a) the Buyer returns any non defective Agreement will be in either the District Court of .Johnson goods covered by this purchase order; or (b) prior to County, Kansas, or the United States District Court, shipment, but after the goods are produced by Seller, Buyer District of Kansas. If any provision of this purchase order cancels the order for the subject goods. is unenforceable, the remaining provisions will remain in effect. No waiver (whether by course of dealing or 7. WARRANTY. Seller's warranty is provided otherwise) is effective unless it is made in writing and separately, signed by the party to be charged with such waiver. Unless otherwise specified in writing, notices must be given in 8. LIMITATION OF LIABILITY. SELLER IS writing by registered or certified mail, return receipt NOT LIABLE FOR ANY CONSEQUENTIAL, requested, addressed to: INDIRECT, OR INCIDENTAL DAMAGES, OR ANY LOST PROFITS OR LOST SAVINGS, EVEN IF A Kustom Signals, Inc. SELLER REPRESENTATIVE HAS BEEN ADVISED OF Attn: Sales Dept. THE POSSIBILITY OF SUCH LOSS, DAMAGES, 9325 Pflumm CLAIMS OR COSTS, NOR IS SELLER LIABLE FOR Lenexa, KS 66215 ANY CLAIM BY ANY THIRD PARTY. SELLER'S AGGREGATE LIABILITY UNDER OR IN Invoice Number 412630 Invoice II I II I IIII I I �I III KUSTOM SIGNALS, INC. Customer Copy I Invoice Date A PUBLIC SAFETY EQUIPMENT COMPANY REMIT TO; 0 1010 W. Chestnut P.O. Box 947 KUSTOM SIGNALS, INC.: Customer Number 166673 673 0 Chanute, KS 66720 -0947 PO BOX 411882 Order Number 158187 SR (620) 431 -2700 Fax (620) 431 -2734 KANSAS CITY, MO 64141 -1882 Customer PO 21848 SOLD TO Page 1 of 1 CARMEL POLICE DEPT SHIP TO POLICE DEPT HDQTRS CARMEL POLICE DEPT 3 CIVIC SQUARE POLICE DEPT HDQTRS CARMEL IN 46032 3 CIVIC SQUARE CARMEL IN 46032 Net Due Date 04/14/10 Terms net 30 Shipping UPS 38114 Quant�fiy =.v parNuiiibei�LIESCRIP"TIOPI% Serial g Price A xtended Shy w w�d;,� i W.'2111, KK 1 064- 0068 -OOR PRO -1 MODS Serial Number(s) DSO4610 38114 DSO4610 OW 7 -15 -99 No audio /squelch Jason Ogle 317 733 =4600 FAX 317- 733 =6527 jogle @carmel, in.gov 1 888- 8888 -38 CS FREIGHTGROUND 11.00 11.00 INBOUND SHIPPING CHARGES 1 155 3176 -00 CABLE, SPEAKER ASSEMBLY 12.70 12.70 1 222 2312 -01 CS RADAR ROAD TEST ASSESSMENT 15 111- 1111 -13 OOW Radar Labor tenths of hr 7.50 112.50 OOW Radar Labor tenths of hr DS 04610 COUNTING UNIT ONLY. REPLACED SPEAKER, (INOP). ROAD TESTED FUNCTION TESTED. REMIT TO: FEDERAL ID 43- 1757730 Subtotal 136.20 KUSTOM SIGNALS, INC. i Tax 0.00 PO BOX 411882 III I�III�II III��III I II lil KANSAS CITY, MO 64141 -1882 TOTAL 136.20 WWW.KUSTOMSIGNALS.COM Invoice Number 412525 Invoice KUSTOM SIGNALS INC. Customer Copy REMIT TO: Invoice Date 03/12/10 A PUBLIC SAFETY EQUIPMENT COMPANY Customer Number 16673 1010 W. Chestnut 1 P.O. Box 947 KUSTOM SIGNALS, INC. Chanute, KS 66720 -0947 PO BOX 411.882 Order Number 158333 SR (620) 431 -2700 Fax (620) 431 -2734 KANSAS CITY, MO 64141 -1882 Customer PO 21853 SOLD TO Page 1 of 1 CARMEL POLICE DEPT SHIP TO POLICE DEPT HDQTRS CARMEL CLAY COMMUNICATIONS CI 3 CIVIC SQUARE 31 1 STAVE NW CARMEL IN 46032 CARMEL IN 46032 Net Due Date 04/11/10 Terms net 30 Shipping UPS 38197 a0 PA Gular>It>!ty� n Part N4 DE; CRIPTIDNf Senal Plrice Shi ed 1 200 2072 -OOR PRO -LITE REPAIR 38197 LP02793 OW 3 -2 -09 Recertification Brian Smith 317- 571 -2594 FAX 317- 571 -2588 bmsm ith @carmel. in.gov 1 888 8888 -33 CS FREIGHT GROUND 18.00 18.00 OUTBOUND SHIPPING CHARGES 1 064- 0075 -RC PL3 RECERTIFICATION 125.00 125.00 10 111 1111 -11 OOW Laser Labor tenths of hr OOW Laser Labor tenths of hr I recertified the Pro -Lite LP02793 and sent it on road test. 7mm TOTAL Pulse Width Calibraion 13.69 123.3 23.38 19.999729 REMIT TO: FEDERAL ID 43- 1757730 Subtotal 14100 KUSTOM SIGNALS, INC. I III III IIIIIIIIIIII EI� Tax 0.00 PO BOX 411882 I KANSAS CITY, MO 64141 -1882 TOTAL 143.00 WWW.KUSTOMSIGNALS.COM Invoice Number 412526 Invoice KUSTOM SIGNALS, INC. Customer Cop REMIT TO: Invoice Date 03/12/10 A PUBLIC SAFETY EQUIPMENT COMPANY Customer Number 16673 1010 W. Chestnut I P.O. Box 947 KUSTOM.SIGNALS, INC. Chanute, KS 66720 -0947 PO BOX. 411882 Order Number 158334 SR (620) 431 -2700 Fax (620) 431 -2734 KANSAS CITY,'MO 64141 -1882 Customer PO 21853 SOLD TO Page 1 of 1 CARMEL POLICE DEPT SHIP TO POLICE DEPT HDQTRS CARMEL CLAY COMMUNICATIONS CI 3 CIVIC SQUARE 31 1ST AVE NW CARMEL IN 46032 CARMEL IN 46032 Net Due Date 04 /11/10 Terms net 30 a Shipping UPS 38197 "u rc g'"C' �1 1'� 1 �e -a�:'kceP. a1 a.�F ay,� 'w Quartttys art'Niimb "er 'DESCRIPTIONS /•.Srtalm #P C �xts n ded P Shipped,�h �E....��'a���' N 1 200- 2072 -OOR PRO -LITE REPAIR 38197 LP02221 OW 3 -2 -09 Recertification Brian Smith 317 -571 -2594 FAX 317 571 -2588 bmsmith@carmel.in.gov 1 064- 0075 -RC PL3 RECERTIFICATION 125.00 125.00 10 111- 1111 -11 OOW Laser Labor tenths of hr OOW Laser Labor tenths of hr I recertified the Pro -Lite LP02221 and sent it on road test. 7mm TOTAL Pulse Width Calibration 18.05 137.1 26.16 19.999785 REMIT TO: FEDERAL ID 43- 1757730 Subtotal 125 KUSTOM SIGNALS, INC. Tax 0.00 PO BOX 411882 KANSAS CITY MO 64141 -1882 �IIIIII�IIIIIfI�IIIIIIIII TOTAL 125.00 WWW.KUSTOMSIGNALS.COM INDIANA RETAIL TAX EXEMPT PAGE C li Carmel o Ir CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT Z1847 35- 60000972 3QNR•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 VENDOR Kust,om Signal, Inc. SHIP City of Carmel Police Department P.O. Box 411882 TO 3 Civic Square Kansas City, MO 66141 Carmel., IN 46032 ATNN: Jason Ogle CONFIRMATION B=UNIT PAYMENTTERMS FREIGHT QUANTITY DESCRIPTION UNIT PRICE EXTENSION repairs to spareraddar 200.82 RMA #158188 SR WEB 38115 A n Ft E 4F -,,fib L n Cit y of Carmel 1'013 e W Send Invoice To: ATTN: Teresa Anderson 3 Civic Square Carmel, IN 46032 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 1110 500 equipment repairs and main 71 Y ENT 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 THIS APPROPRIATION SUFFICIENTTO PAY FOR THE ABOVE ORDER. SHIP REPAID. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. Chief O f Police THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. I Jj CLERK- TREASURER DOCUMENT CONTROL NO. 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 INDIANA RETAIL TAX EXEMPT PAGE C i t y o 11� C armel CERTIFICATE NO.003120155 002 fl 1 of 1 .u� PURCHASE ORDER NUMBER Pol ice Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 2185 ?O'NEXIVIC SQUARE fTHI NUMBER MUST APPEAR ON INVOICES, A!P CARMEL, INDIANA 46032 -2584 UCHER, DELIVERY MEMO, PACKING SLIPS, PPING 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 March 19, 2010 radar recertification VENDOR Kustom Signals, Inc. SHIP City of Carmel. Police Department P.O. Box 422882 TO 3 Civic Square Kansas City, MO 64141 -1882 Carmel, IN 46032 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION recertification of radar 125.00 recertifi.caiton of radar 143.00 TP.a�., I 1 41 Send Invoice To: PLEASE INVOICE IN DUPLICATE 268.00 DEPARTMENT ACCOUNT I PROJECT I PROJECT ACCOUNT AMOUNT 1110 500 equipment repair And maint 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 VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS HEREBY CERTI IS ,ANICJNOBLIGATED BALANCE IN THIS APPROPFIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. SHIP REPAID. C.C.D. SHIPMENTS CANNOT BE ACCEPTED, PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY r SHIPPING LABELS. 4 sistant Chief of Police THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO, 1 CLERK- TREASURER DOCUMENT CONTROL NO. A� 4 COPY SIGN AND RETURN TO CLERK OFFICE VOUCHER NO, WARRANT NO. ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR Board Members PQ# or INVOICE NQ. ACCT #fTETLE 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 2© Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund Ci INDIANA RETAIL TAX EXEMPT PAGE f C sane CERTIFICATE N0. 003120155 002 0 ^f PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 la 30f�1ff.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 PU RCHASE ORDER D ATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION March 11. 2010 reps tts VENDOR Kustom Signals, Inc. SHIP City of Carmel Police Department P.O. Box 411882 TO 3 Civic, Square Kansas City, MO 64141 Carmel, IN 40032 ATTNt Jason Og &e CCNrmmmON BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION repairs to radar for car 56 R. Harris 136.20 3 IN •P x I Send Invoice To: City of Carmel. Pol e ATTN 'Teresa Anderson 3 Civic Square Cars &1,I5N46e032 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT I PROJECT I PROJECT ACCOUNT AMOUNT 1110 500 equipment repairs aqlh ma-1.16t PAMENT 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. d f yi PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY }�4 SHIPPING LABELS. Chief of POIiC� THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT.THERETO. �j CLERK TREASURER DOCUMENT CONTROL NO. A•P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR a 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 ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) CITY OF CARMEL An invoice or bill to be properly itemized must snow: 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 'Kustom Signals, Inc. Purchase Order No. 21848F 21853F 21847F P.O. Box 411882 Terms Kansas city, MO 64141 -1882 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 3112/10 412517 payment for repairs to radar 200.82 3/12/10 412525 paymetn for radar recertification 143.00 3/15/10 412630 paynient for repairs to radar 136.20 1/19110 41252.6 payment for radar rerertifirAtfon 125,00 Total 605.02 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 K ustom Signals, Inc. IN SUM OF P.O. Box 411882 Kansas City, MO 64141 -1882 005.02 ON ACCOUNT OF APPROPRIATION FOR p olice general fund Board Members Po# or INVOICE NO. ACCT /TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 21848F 412630 500 136.20 bill(s) is (are) true and correct and that the 21853E 412525 500 143.00 materials or services itemized thereon for 21847F 412517 500 200.82_' which charge is made were ordered and 21853F 412526 500 125.00 received except March 25 20 10 Signature Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund