190243 09/29/2010 CITY OF CARMEL, INDIANA VENDOR: 364719 Page 1 of 1
ONE CIVIC SQUARE DECHANT CONSULTING SERVICES -D C GHECK AMOUNT: $158.00
CARMEL, INDIANA 46032 PO BOX 3261
BELLEVUE WA 98009 -3261 CHECK NUMBER: 190243
CHECK DATE: 9/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239099 27024 150.00 REPLACEMENT DONGLE
1110 4342100 27024 8.00 REPLACEMENT DONGLE
INVOICE
Date: September 22, 2010
Sold to: City of Carmel Police Department
3 Civic Square
Carmel, IN 46032
Replacement dongle
TOTAL AMOUNT DUE: $1.58.00
Please make check payable to:
DeChant Consulting Services DCS Inc.
P.O. Box 3261
Bellevue, WA 98009 -3261
ATTN: Lee DeChant
INDIANA RETAIL TAX EXEMPT PAGE
C ity of'Carme CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT 2x024
35- 60000972
37�,�n IVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARh�EL, I 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 1 SHIPPING LABELS AND ANY CORRESPONDENCE.
°URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
a ement don le
SHIP
VENDOR .Consulting Services DCS Inc. City of Carmel Police Department
P.O. Box 3261 TO 3 Civic Square
Bellevue, WA 98009 3261 Carmel, IN 46032
ATTN: Lee DeChant ATTN: Sgt. Amy Stein
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1 replacement dongle. 150.00
shippAng 8.00
390 -99 $150.00 =,n
421 8.00
V °.4.
Send Invoice To: �f^ r 7
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 390 other miseellan ous PAYMENT
1110 4s21 postage 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.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. �f
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief Of Force
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 2 7 ®2 4 A.P.V. COPY SIGN AND RETURN TO C LERK' S OF FICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
S
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #FFITLE 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
DeChant Consulting Services DCS, Inc. Purchase Order No. 27024F
P.O. Box 3261 Terms
Bellevue WA 98009 -3261
ATTN Lee DeChant Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9/22/10 a ent for replacement don le 158.00
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.
s
20
Clerk Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
DcZhant Consulting Services DCS Inc. IN SUM OF
P.O. Box 3261
Bellevue, WA 98009 -3261
ATTN: Lee DeChant
158.00
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
27024F 390 -99 150.00 bills) is (are) true and correct and that the
27024F 421 8:00 materials or services itemized thereon for
which charge is made were ordered and
received except
September 22 20 10
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund