HomeMy WebLinkAbout191745 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 363647 Page 1 of 1
ONE CIVIC SQUARE MEDTECH FORENSICS, INC
CHECK AMOUNT: $210.95
CARMEL, INDIANA 46032 4369 HUGGINS HILL LANE
TALLAHASSEE FL 32311
CHECK NUMBER: 191745
CHECK DATE: 1111012010
D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4342100 13118 17.00 POSTAGE
1110 4239099 27044 13118 193.95 LAB SUPPLIES
ME DTECH. Forensics, Inc. Invoice
4369 Huggins Hill Lane
Tallahassee, FL 32311-0731 Date Invoice
(850) 878 -7061 10/27/2010 1.3118
(850) 878 -6103 FAX
Bill To Ship To
Carmel Police Department Carmel Police Department
3 Civic Square 3 Civic Square
Carmel, 1N 46032 Carmel, IN 46032
Attention: Teresa Anderson Attention: John Elliott
Attention: P.O. 427044
P.O. Number Terms Rep Via Due Date
P.0.#27044 Net 30 UPS 11/26/2010
Quantity Item Code Description Price Amount
1 3309 Physical Developer Pre- Weighed Chemical Kit 39.95 39.95
8 ORC -9266 Mr. T- Square, Fractional, 4X6, White, 5.00 40.00
(4TSF- WH4X6D)
2 3152 RTX, 60mL 57.00 1.14.00'
1 SH Shipping and Handling 17.00 17.00.
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Thank you for your business. Total $210.95
www.medtechforensics.com
INDIANA RETAIL TAX EXEMPT PAGE
Carme CERTIFICATE NO. 003120155 002 0 1 -.9 1
PURCHASE ORDER NUMBER
O Police. Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 27044
gb5�CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/F
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS
SHIPPING LABELS AND ANY CORRESPONDENCE
'ORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
HCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO- DESCRIPTION
tober 7 2010 lab supplies
iENDOR Medtech Forensics, Inc. SHIP City of Carmel Police Department
4369 Huggins Hill Lane To 3 Civic Square
Tallahassee, FL 32311 Carmel, IN 46032
ATTN: Jobn Elliott
)NRRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY I UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Qak to #1226
1 3304 Malefic Acid Prewash, 1. liter 13.95
1 3309 Ph)sybcal Developer Pre Weighed. C mical Kit 39.95
8 ORC -9266 Mr. T- Aquare, Fractional, 4x6, calcite 5,00 40.00` eN
2 3152 RTX, 60m1 57..00 114:.00r
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Send Invoice To: City of Carmel Police Depar
y
ATTN: Teresa Anderson'
3 civic Square
Camel, IN 46032
PLEASE INVOICE IN DUPLICATE
?()7 a
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1.110 390 -99 other miscellaneous 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 APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
1 d9 mf r/! 1.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY J
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of olice
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
f�
CLERK TREASURER
)OCUMENT CONTROL NO. 27 044 4 A.P.V. COPY SIGN' AND RETURN TO CLERK'S OFFICE
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 2p1(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
Medtech Forensics, Inc. Purchase Order No. 27044P
4369 Huggins Hill Lane Terms
Tallahassee, FL 32311 -0731 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10/27/1 1 118 a etn for lab supplies 210.95
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
M edtech Forensics, Inc. IN SUM OF
4369 Huggins Hill Lane
Tallahassee, FL 32311 -0731
210.95
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
27044P 13118 390 -99 193.95 bill(s) is (are) true and correct and that the
1110 1.3118 421 17.00 materials or services itemized thereon for
which charge is made were ordered and
received except
November 4 20 10
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund