185991 05/26/2010 CITY OF CARMEL, INDIANA VENDOR: 354377 Page 1 of 1
ONE CIVIC SQUARE U.S. UNIFORM SUPPLY INC
CHECK AMOUNT: $314.90
CARMEL, INDIANA 46032 615 N DELAWARE ST
INDIANAPOLIS IN 46204 CHECK NUMBER: 185991
CHECK DATE: 5/26/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4342100 55236 15.00 POSTAGE
1110 4467099 26911 55236 299.90 FLASHLIGHTS
US UNIFORM SUPPLY Invoice
815 N. Delaware St.
Indianapolis, IN 46204 Invoice 55236
317- 822 -8166 Account PDCARMEL
317- 822 -8167 Page: 1 of 1
Date: 5/13/2010
Time: 5:25:28 PM
Cashier: 6
Register 1
Bill To: ACCOUNTS PAYABLE Ship To: STORE ORDER
CARMEL POLICE DEPARTMENT DEPARTMENTAL BILLING
3 CIVIC SQUARE
CARMEL, IN 46032
317.571.2500
Reference: ROBERT
Comment: PO #26911
Rep tem LookupCode �Descnpton r.u. .art 0uantity
i
F -v Pricef €Wkr .Extended
LB 080926758131 STREAMLIGHT STINGER DS LED 2 $149.95 $299.90
INCLUDES FLASHLIGHT AC /DC
CHARGERS AND BATTERY
LB UPS UPS SHIPPING GROUND 1 $15.00 $15.00
APPROVED BY ROBERT
.�E,�o e. 2. r. a .r as
E �,��Ed w �.a
Thank you for shopping Sub Total $314.90
US UNIFORM SUPPLY Sales Tax $0.00
Please come again! Total $314.90
Store Account $314.90
Previous Balance $0.00
New Balance $314.90
Change Due $0.00
55236
INDIANA RETAIL TAX EXEMPT PAGE
Ci ®7f C arme l CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972
3W 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
DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
May 1 3 2010 flashlights
VENDOR US Uniform SUPPly SHIP City of Carmel Police Department
815 N. Del re Street TO 3 Civic Sggsse
Indianapolis, IN 46204 Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY I UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
2 Streamlight Stinger DS LED 149.99 288.96
A
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 670 -99 other equip�aaat 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 I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPR PRIIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D.. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of PO &ice
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL No-26911 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
:TOUCHER 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 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
US UNiform Supply Purchase Order No. 26911F
815 N. Delaware Street Terms
Indianapolis, IN 46204 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
5/13/10 55236 payment for flashlights 31.
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
VOI NO. WARRANT NO.
ALLOWED 20
US Uniform SUPP 1
IN SUM OF
815 N. Delaware Street
Indianapolis, IN 46204
314.90
ON ACCOUNT OF APPROPRIATION FOR
police genera lfund
Board Members
PO# or D PT. INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or
26911F 55236 670 -99 299.90' bill(s) is (are) true and correct and that the
1110 55236 421 15.00 materials or services itemized thereon for
which charge is made were ordered and
received except
May 17 20 10
ignature
Assistant Chief of Poli
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund