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HomeMy WebLinkAbout194996 03/02/2011 CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1 ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $603.38 CARMEL, INDIANA 46032 7001 WOOSTER PIKE MEDINA OH 44256 CHECK NUMBER: 194996 CHECK DATE: 3/2/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 900 4359005 27281 168586 603.38 CAR SEATS Invoice Invoice Number: 0000168586 7001 Wooster Pike, Medina, OH 44256 Ph: 330.723.4739 Fax: 330.721.6799 Invoice Date: 2/16/2011 REMI'T'TANCE ADDRESS: Invoice Due Date: 3/18/2011 WESTERN RESERVE DISTRIBUTING, INC. Custo dba CHILD SOURCE mer° CARMPD P.O. BOX 73714 Sales Order: 0000098818 CLEVELAND, 01 -1 44193 Tax ID #82- 056 3593 Sold Toy; Ship I'o CARMEL POLICE DEPARTMENT, CITY TRINITY CLINIC 3 CIVIC SQUARE 1045 W 146TH STREET CARMEL, IN 46032 -2584 USA Carmel, IN 46032 USA C �Custeme RO Shrp Vra R F.O.I3 Terms 27281 FEDEX GRND ORIGIN Net 30 Days It em T Dzscrip T_QtY tapped Unit Price. A mount 3 ICO34AOB SAFETY 1st DESIGNER CARSEAT 5 -22# W /BASE 5 63.9000 319.50 (NORDICA) 93- 209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 4 47.2000 188.80 LAST ITEM Tracking Numbers: 06644371 51 1 4970, 06644371 51 1 4987, 06644371 51 1 4994, 06644371 51 1 5007, 066443715115014, 06644, Subtotal 508.30 Frei.,ht 95.08 Sales Tax 0.00 Payment /Credit Amount 0.00 _y Balance 603.38 C o INDIANA RETAIL TAX EXEMPT PAGE 1 of C rme CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 27ni 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 DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO, VENDOR NO. DESCRIPTION Child Soums T P�1O ,r SHIP ti VENDOR 7009 Wooster Pilo TO Medina, Obi 44M _v.tuui(- 'Lau.. E��.c..ct daa+i�cw CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT g QUANTITY ���gUNIIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Arco BF1g 8+O.M.03 1 Each shipping $95.08 $95.08 4 Each High Back Booster Front Adj 93-209FSM $47.20 $188.80 5 Each Safety 1 st Designer Car Seat 1CO3wt $03.90 $319.50 r Sub Total: $803.38 4r •A n -A P Send Invoice To: Carmel Police Department Attn: Tomsaa Anderson 3 CIVIC sgum Camoi, IN 462- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Caul Poilce Dopt. 6 PAYMENT .38 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'fHJA fT ERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROP IA 10 SU FICIENT TOP AY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL ahl SHIPPING LABELS. Police THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK TREASURER DOCUMENT CONTROL NO. 27281 A.P,V. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. NO. ALLOWED 20 IN THE SUM OF S 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. ALLOWED 20 Child Source IN SUM OF 7001 Wooster Pike Medina, OH 44256 $603.38 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Grant Fund PO# Dept. INVOICE NO. ACCT #ITITLE AMOUNT Board Members 27281 168586 590.05 $603.38 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 Wednesday, February 23, 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)) 02/16/11 168586 payment for car seats $603.38 1 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