195900 03/29/2011 CITY OF CARMEL, INDIANA VENDOR: 364574 Page 1 of 1
Q ONE CIVIC SQUARE ENTERPRISE MARKETING PRODUCTS CHECK AMOUNT: $476.00
CARMEL, INDIANA 46032 15309 STONY CREEK
NOBLESVILLE IN 46060 CHECK NUMBER: 195900
CHECK DATE: 3/29/2011
DEPARTMENT ACCOUNT PO NUMBE INVOICE NUMBER AMOU DE SCRIPTION
1110 4230200 27737 9163 476.00 PERFORATED ROLL
Technical Group ��VOG�
4 n s wREMIT TO:
�E A,EMP Technical Group
X15309 Stony Creek Way
Date Invoice
oblesville, IN 46060
317 -776 6700 3/17/2011 9163
1 \'3!,III7IIrM1 11LM \I PR�f)II:Yi.1 \l:.
Bill To Ship To
City of Carmel Police Department City of Carmel Police Department
3 Civic Square 3 Civic Square
Carmel, IN 46032 Carmel, IN 46032
Attn: Teresa Anderson Attn: Robert Robinson
P.O. Number Terms Rep Ship Via F.O.B.
27737 Net 30 BV 3/16/2011 Fed Ex Ground Factory
Quantity Item Code Description U/M Price Each Class Amount
10 LB3663 -CASE Perforated roll, 6 roll pack, 100 sheets per ea 45.00 7386 450.00
roll, priced per pack.
Shipping Shipping /Handling 26.00 7386 26.00
Thank you for your business. Total i $476.00
Phone Fax
317- 776 -6700 317 -219 -0535
INDIANA RETAIL TAX EXEMPT PAGE
C i dc-' J! Ca r l CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2rW
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.
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
369 9
EMP Technical Group Cool Police DGpmdmgnt
VENDOR SHIP 3 CIVIC squm
97 Tiiior CouK TO Ca rme l, I N 41
u leld, IN 46074 (317) 571
0ONFIRMA710N BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-M2.00
Each Perforated Ta il L83663 $43.00 $450. 00
Sub Total: $450.00
Send Invoice To:
Camel Police Departmont
Attu: Toroaa Andoraon
3 CIVIC squ2
CzrmGI, IN PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Camel Police Dept. P� PAYMENT '00
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 S BFIC AT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. �e yea lef o Police
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE IC[ Ir
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO-
CLERK-TREASURER
DOCUMENT CONTROL NO. 27737 A.F.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.�
ALLOWED 20
IN THE SUM OF S
ON ACCOUNT OF APPROPRIATION FOR y
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 it
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
EMP Technical Group
IN SUM OF
I N 46e�7
$476.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
27737 963 42- 302.00 $476.00 E 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, March 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))
03/17/11 9163 payment for paper rolls for e- ticketing $476.00
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