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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