192319 11/23/2010 "yF CITY OF CARMEL, INDIANA VENDOR: 364859 Page 1 of 1
ONE CIVIC SQUARE SALTZMAN GUN WORKS CHECK AMOUNT: $185.00
3896 S 400 WEST CARMEL, INDIANA 46032
TIPTON IN 46072 CHECK NUMBER: 192319
CHECK DATE: 11/2412010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350000 27064 321 185.00 RIFLE REPAIRS
L
Saltzman Gun Works, Inc.
3896 South 400 West I nv oi ce
r� elm" An. Tipton, IN 46072
765 -675 -2040 Invoice 321
Date 11/13/2010
Bill To Ship To
Carmel Police Dept. Carmel Police Dept.
Teresa Anderson
3 Teresa Anderson
Civic Square
Carmel,IN 46032 3 Civic Square
Carmel, IN 46032
Manufacturer/ Modell Serial Number /Finish Magazine Case
Remington F6747999 E6615703 No
Description Qty Rate Amount
Cut barrel to 20 inches and recrown 2 70.00 140.00
Repair stripped out threads in receiver for the scope mount on rifle 1 45.00 45.00
E6747999
P. O. #27064
Subtotal $185.00
Sales Tax (7.0 $0.00
Payments /Credits $0.00
It's been a pleasure working with you?
To $185.00
INDIANA RETAIL TAX EXEMPT PAGE
CERTIFICATE NO. 003120155 002 0 o
c i t of PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 2706
3f (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
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
November 2 2010 rifle repairsz
SHIP
VENDOR
E t TO City of Carmel P olice Department
3 Civic Square
I
Carmel,, IN 46032
Sg Adam Mil&er
CONFIRMATVON BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
3 rifle repairs 70.00 210.00
VA
I
r
Send Invoice To: z
Cit�yo6 Carmel Police -�Dep x:tme4t'
ATTN: Teresa Anderson`
3 Civic Square
Carmel, IN 46032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 500 equipment repairs a maint SENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE APART 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
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO. 2 7 ®6 4 A.P.V. 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
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
Saltzman Gun Works, Inc. Purchase Order No. XXIV, 27064F
3896 South 400 West Terms
Tipton, IN 46072 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
t 11/8 10 318 a ent for rifle re airs 13/1 321 payment for rifle repairs 185.00
Total 255.00
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
Saltzman Gun Works, Inc.
IN SUM OF
3896 South 400 West
Tipton, IN 46072
XXVJM 255.00
ON ACCOUNT OF APPROPRIATION FOR
police generalf and
Board Members
PO# or D PT. INVOICE NO. ACCT /TITLE AMOUNT I hereby certify that the attached invoice(s), or
27064 318 500 70.00 bill(s) is (are) true and correct and that the
27064F 321 500 140.00 materials or services itemized thereon for
1110 321 500 45.00 which charge is made were ordered and
received except
November 16 20 10
Signature
Chief' of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund