HomeMy WebLinkAbout194139 02/03/2011 CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1
0 ONE CIVIC SQUARE CHILD SOURCE
CARMEL, INDIANA 46032 7001 WOOSTER PIKE CHECK AMOUNT: $729.30
oN MEDINA OH 44256 CHECK NUMBER: 194139
CHECK DATE: 2/3/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
852 5023990 27246 167084 129.30 CARSEATS /BOOSTERS
900 4359005 27246 167084 600.00 CARSEATS /BOOSTERS
�-,;ed source- Invoice
INAWNWA AMMMAil MIS Invoice Number: 0000167084
7001 Wooster Pike, Medina, 0I -1 44256
Ph: 330.723.4739 Fax: 330.721.6799 Invoice Date: 1/14/2011
REMITTANCE ADDRESS: Invoice Due Date: 2/13/2011
WES'T'ERN RESERVE DIS'T'RIBUTING, INC. Customer: CARMPD
dba CHILD SOURCE
P.O. 13OX 73714 Sales Order; 0000098226
CLEVELAND, 01-1 44193
T ax ID 982- 0563
SpldTa z_..._..__.�_S to
CARMEL POLICE DEPARTMENT, CITY CARMEL POLICE DEPARTMENT
3 CIVIC SQUARE 2 CIVIC SQUARE
TERESA ANDERSON ATTN ANN 317 -571 -2720
CARMEL, IN 46032 -2584 USA Carmel, IN 46032 USA
Gistomer P'O -Shi Via -t C B s �rTer;i
m
27246 FEDEX GRND ORIGIN Net 30 Days
ip t�on M" t. Q ty.5hipp ed °U ii�txPr ice `:Amouilr
ICO34AOB SAFETY Ist DESIGNER CARSEAT 5 -22# W /BASE 4 h390i ?0 255.60
(NORDICA)
93- 12OFSM SCENERA 4 HNS POS (2 /PK) 4 43.0000 172.00
93- 209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 4 47.2000 S 1$5.80
LAST ITEM
�t
Tracking Numbers: 066443715085546, 066443715085553, 066443715085560, 066443715085577, 066443715085584, 06644;
Subtotal 616.40
Freight 112.90
Sales Tax 0.00
Payment/Credit Amount 0.00
E 771 1 -7717
Z.Balanee 729.30
INDIANA RETAIL TAX EXEMPT PAGE
City o C arme� CERTIFICATE NO.003120155 002 D PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 27246
35- 60000972
ONE 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. VENDOR NO. DESCRIPTION
1/9212011
Child Raurco CmI,'I of Policy DopaKmont
3 Chic Squm
v""%3 SHIP
oostGr Plho TO C@rmol, IN
Modim, Ofd 44266 (317) 571
CONFIRMATION BLANKET CONTRACT PAYM ENT T FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 00462.0
9 Each Shipping $112.90 $112.90
4 Each Scenora 4 HNS P'OS 93- 120FSM $43.00 $172.00
4 Each Sam 1 s9 Designer Carseat ICO34AOS $03.90 $255.80
4 Each High Rack Booster Front AD.i 93`=2 $$47.20 $188.80
r Sub Total: $7
I
AN 4
0 r R
4
i� s
p i
Send Invoice TO:
Cl of pnllco Dopaltment
Attn: Tomsa Anderson
3 CIVIC Squaw
Carmel, IN 4f3— PLEASE INVOICE IN DUPLICATE
DEPART,( NT ACCOUNT PROJECT PROJECT ACCOUNT /1 (JUNT
Carmel �I r] O`'cc 1 4b �AYMENT
C- ,n A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
LLJJ VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS HEREBY CERTIFY THA ER€ IS AN UNOBLIGATED BALANCE IN
SHIP REPAI).
THIS APP ROP RIAILOWSUFFIGI ENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.' i�1 fll poilco
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 27 2 4 6 A.P.V. COPY SIGN AND RETURN TO CLERIC OFFICE
VOUCHER NO, WARRANT
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Child Source
IN SIAM OF
7001 Wooster Pike
Medina, OH 44256
$729.30
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Grant Fund
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
I hereby certify that the attached invoice(s), or
27246 167084 590.05 o
bill(s) is (are) true and correct and that the
I L 3
materials or services itemized thereon for
which charge is made were ordered and
received except
Friday, January 28, 2011
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. 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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
01/14/11 167084 payment for car seats $729.30
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