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HomeMy WebLinkAbout193397 01/05/2011 CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1 ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $1,179.35 CARMEL, INDIANA 46032 7001 WOOSTER PIKE MEDINA OH 44256 CHECK NUMBER: 193397 CHECK DATE: 1/5/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 R4342100 27112 166001 113.75 CAR SEATS 852 R5023990 27112 166001 753.60 CAR SEATS 900 R4359005 27112 166001 312.00 CAR SEATS Z ild Invoice Invoice Number: 0000166001 7001 Wooster Pike, Medina Ohl 44256 Ph: 330.723.4739 Fax: 330.721.6799 Invoice Date: 12/16/2010 REMITTANCE ADDRESS: Invoice Due Date: 1/15/2011 WESTERN RESERVE DISTRIBUTING, INC. dba CHILD SOURCE Customer: CARMPD P.O. BOX 73714 Sales Order: 0000097725 CLEVELAND, 0I -1 44193 Tax ID 982- 0563593 Sotd 3= 1. 7 Shi o CARMEL POLICE DEPARTMENT, CITY CARMEL POLICE DEPARTMENT 3 CIVIC SQUARE 3 CIVIC SQUARE CARMEL, IN 46032 -2584 USA ATTN ANN GALLAGHER Carmel, IN 46032 USA 27112 FEDEX GRND ORIGIN Net 30 Days Descri T Qt} ShEpp -llmtU i'r�ce¢ Am ount 61472.65 CHICCO KEY FIT 30# ADVENTURE INFANT SEAT 6 125.6000 753.60 93- 120f=SM SCENERA 4 HNS POS (2 /PK) 4 43.0000: 172.00 2794198 BIG KID NO BACK BOOSTER 40- 100# 8 17.5000 140.00 LAST ITEM Tracking Numbers: 066443715062660, 066443715062677, 066443715062684, 066443715062691, 066443715062707, 06644: Subtotal 1,065.60 Freig,ht 113.75 Sales Tax 0.00 Payment /Credit Amount 0.00 1.179.35 INDIANA RETAIL TAX EXEMPT PAGE C i ty o rme� CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 2 3 9_4XCIVIC 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 PURCHAS ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION December 15.2 10 car seats VENDOR Child Source SNIP City of Carmel Police Department 7001 Wooster Pike TO 3 Civic S>ggare Medina, OH 44256 Carmel, IN 46032 ATTN: Ann Gallagher CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION 6 61472.65 Chicco Key fit 30# Adventure Infant Seats 125.60 753.60 4 93- 12OFSM Scenera 4HNS pos 43.00 172.00 8.00 2794198 Big Kid No Back Booster 17.50 140.00 shipping 113.75 421 $113 852 $753 590 -05 n $312 Q y- City of Carmel Polls "e pepartmeAt Send Invoice To: son ATTN: Teresa Ander 1 3 Civic Square Carmel, IN 46032 PLEASE INVOICE IN DUPLICATE 1,179.35 DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 1110 421 posSage PAYMENT 852 852 police gif fund A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. 900 590 -05 car seat grant f und NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS i HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFFICIENTTO PAY FOR THE ABOVE ORDER. //O RDERED C.O.D. SHIPMENTS CANNOT BE ACCEPTED. BY `Y. PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. EY► L THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Polies AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. qq CLERK- TREASURER DOCUMENT CONTROL NO. 27 12 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 2© Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund VOUCHER NO. WARRANT NO, Child Source ALLOWED 20 IN SUM OF$ 7001 Wooster Pike Medina, OH 44256 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members llh'o Y Eacumher d I hereby certify that the attached invoice(s), or 27112 166001 43- 421.00 $113.75 cam, bill(s) is (are) true and correct and that the ?�L i (1(�I 0�� j, materials or services itemized thereon for D 1 n i which charge is made were ordered and �71r�nF� ti� vt received except Friday, December 31, 2010 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev. 1(J95) 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 12/16/10 166001 payment for shipping charges $113.75 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