HomeMy WebLinkAbout195375 03/16/2011 CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1
ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $430.04
CARMEL, INDIANA 46032 7001 WOOSTER PIKE
Dry co MEDINA OH 44256 CHECK NUMBER: 195375
CHECK DATE: 3/16/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
900 4359005 27301 169347 430.04 BOOSTERS
child s
ources Involve
Invoice Number: 00001 69347
7001 Wooster Pike, Medina, 01 -I 44256
Ph: 330.723.4739 Fax: 330.721.6799 Invoice Date: 3/3/2011
REMITTANCE ADDRESS: Invoice Due Date: 4/2/201
WESTERN RESERVE DISTRIBUTING, INC. Customer: CAR.MPD
dba CHILD SOURCE
Y.O. BOX 73714 Sales Order: 0000099145
CLEVELAND, 01 -1 44193
Tax ID #182- 0563593
S old To S hip TO
CARMEL POLICE DEPARTMENT, CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 W 146TH STREET
CAR.MEL, IN 46032 -2584 USA Carmel, IN 46032 USA
Customer P O Sfzip Via; n R e O B fe rins _l
27301 FEDEX GRND ORIGIN Net 30 Days
Item Descri Qty Shipp Unit Yrice Amount
93 209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 4 47.2000 188.80
93- 12OFSM SCENERA 4 FINS POS (2 /PK) 4 S 43.€1000 172.00
LAST LI'EM
Tracking Numbers: 066443715130277, 066443715130284, 066443715130291, 066443715130307
Subtotal 360.80
Frei .,ht 69.24
Sales Tax 0.00
Payment /Credit Amount 0.00
Balance 430.04
INDIANA RETAIL TAX EXEMPT PAGE
C of Carmel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 01
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
U RC HHA SSpp E ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
Child 'Roureo
i ckf
VENDOR SHIP i �V
il TO
7001 Woostorl"Ilho
Nodin CIS 44256 r}n
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 00-M.05
4 Each High Back Booster Fraffl Adj 93- 209FSM $47.20 $988.80
4 Each Sc enera 4 HN P0S 93-12OFSM $43.00 $172.00
Sub Total: $300.80
e7 1411
6
Send Invoice To:
`F
Camel Police Department
Attn: Teres@ Anderson
3 Civic Squara
Cannel, IN 48=- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT MOWN L
Carmel Police Dept. PAYMENT M 80
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,SSU� TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL fc
SHIPPING LABELS. ��:E�� 4f PQiice
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL No-27301 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO._ WARRANT NO.----
ALLOWED 20
IN THE SUM OF
c oa
ON ACCOUNT OF APPROPRIATION FOR
Board Members
or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
bills) 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
.._.W.._____ Title
Cost distribution ledger classification it
claim paid rnotor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
Child Source
IN SUM OF
7001 Wooster Pike
Medina, OH 44256
$430.04
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Grant Fund
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
37301 169347 590.05 $430.04 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
Thursday, March 10, 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))
03/03/11 169347 payment for car seats $430.04
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