189265 08/31/2010 CITY OF CARMEL, INDIANA VENDOR: 00352583 Page 1 of 1
ONE CIVIC SQUARE BROWNELLS INC
..o CARMEL, INDIANA 46032 200 S FRONT STREET CHECK AMOUNT: $242.74
MONTEZUMA IA 50171 -1000 CHECK NUMBER: 189265
CHECK DATE: 8/31/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239010 27008 6125179 202.79 SLINGS
1110 4342100 27008 6125179 39.95 SLINGS
INVOICE 0 6 1 2 5 1 7 9. 4 0
.08/23/2010 07:52:56 B ROWNE L L S I NC (46032- CITY)179.00
08/23/201.0 08:21:59
200 SOUTH FRONT STREET ritaw -C
DATE SHIPPED: 08/23/2010 MONTEZUMA, IOWA 50171 -1000 DLR GVN IAR
ACCOUNT 00296101 800 -741 -0015 991T
24 HR. FAX (641) 623 -3896 U4 P4
SOLD TO:
CITY OF CARMEL POLICE DEPT. Federal I.D. #42 0838235
ATTN: TERESA ANDERSON I N V O I C E
3 CIVIC SQUARE
CARMEL, IN 46032
SHIP VIA: UPS NEXT DAY
PAYMENT METHOD: OPEN ACCOUNT
SHIP TO:
CARMEL POLICE DEPT. TERMS: NET 30
ATTN: SGT JELLISON
3 CIVIC SQUARE
CARMEL, IN 46032 FINAL
PHONE: (317) -571--2500
FAX 317 -571 -2507 INVOICE
PICKER: 672 PRICER: 614
STOCK PRODUCT QTY QTY 8/0, RETAIL UNIT TOTAL
NUMBER LOCATION NAME AND DESCRIPTION ORDERED SHIPPED N OR C PRICE PRICE PRICE
100 000 -669 J12C04B V -TAC QUICK ADJUST SLING 7 7 34.99 28.97 202.79
ORDER ON THE WEB AT www.brOwnellS.COm
ORDER TOTAL: 202.79
UPS NEXT DAY: 39.95
F LEA-St REMU'T GA-Lk
GRAND TOTAL: 242.74
CASH: 0.00 CC: 0.00, OA: 242.74 COD: 0.00 DUE: 0.00 MB: 0.00 FIC
i
INDIANA RETAIL TAX EXEMPT PAGE
C f Carmel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972
3= 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. rVENDOR NO. DESCRIPTION
Aa1gust 24, 201 C
VENDOR Brownells, Inc.
SHIP City of Carmel Police Department
200 South Front Street TO 3 Civic Square
MOntezuma, IA 50171 -1000 Carmel, IN 46032
CONFIFMAnON BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
7 slings 28097 202079
shipping 39.95
Aw
390 -10 a $202.79
421 °$39.95 y
e 1 y
a> vN
Send invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 390 -10 tMo and accessories PAYMENT
111 421 pos tage 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 MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief 66 Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THE
DOCUMENT CONTROL NO. 2 7 0 Q A .P.V. 8
CLERK-TREASURER
SI SURER
COPY -SGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. NO.
ALLOWED 20
IN THE SUM OF
W
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #Fr[TLE 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
_.Y.___ Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed t;y 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
Brownells, Inc. Purchase Order No. 27008F
200 South Front Street Terms
MOntezuma, IA 50171 -1000 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
8/23/10 6125179 payment for slings 242.74
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,rownells, Inc. IN SUM OF
200 SOuth Front Street
I
Montezuma, IA 50171 -1000
—r
242.74
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
Po# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT, I hereby certify that the attached invoice(s), or
27008F 6125179 390 -10 202.79 bill(s) is (are) true and correct and that the
27008F 6125179 421 39.95 materials or services itemized thereon for
which charge is made were ordered and
received except
August 26 20 10
_Aotba-a-b 71.,wiIi
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund