196260 04/13/2011 CITY OF CARMEL, INDIANA VENDOR: 00352419 Page 1 of 1
0 ONE CIVIC SQUARE BELL TECHLOGIX INC CHECK AMOUNT: $176.40
CARMEL, INDIANA 46032 PO BOX 823342
oe'io PHILADELPHIA PA 19182 -3342 CHECK NUMBER: 196260
CHECK DATE: 4/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPT
1110 4239099 27300 BI299032 176.40 POWER ADAPTER
MTechlogix
PAGE: 1
Focused Skilled Reliable INVOICE: BI 299032
REMIT TO:
BELL TECHLOGIX INC INVOICE DATE: 0 3 2 3 11
P.O. BOX 823342 DUEDATE:04 /22/11
PHILADELPHIA PA 19182 -3342 TERMS: Net 30
317 704 -6000
866- 782 -2355 Net 30 Days
SHIP TO: BILL TO: 1201825
Carmel Police Department CITY OF CARMEL
3 Civic Square ONE CIVIC SQUARE
Carmel IN 46032 ATTN: ACCOUNTS PAYABLE
CARMEL IN 46032
USA
ORDER: 678911
ORDER DATE: 03/17/ 11
CUSTOMER P.O.: 2 7 3 0 0
CARRIER:
FREIGHT TERMS:
METHOD:
TRANSPORTATION ID:
SALESPERSON: SETH SCHWARTZBACH
CURRENCY: United States Dollars NET AMOUNT
DESCI
Carme Po Ice Department
Terry Crockett
Cust PO Num: 27300
Contact name: Terry Crockett
Phone: 3175712567x
Email: tcrockett @carmel.in.gov
BELL SO 678911 20090085
1 ED494AA #ABA 3 EA 176.40
65W SMART AC ADAPTER US 58.80 EA
PAST DUE ACCOUNTS CARRY INTEREST AT THE
LESSER OF 1.5% PER MONTH OR THE
MAXIMUM LEGAL RATE IN THE JURISDICTION
IN WHICH THE CUSTOMER'S PRINCIPAL PLACE
OF BUSINESS IS LOCATED
ALL DELIVERY TERMS ARE F.O.B. ORIGIN
TO REQUEST A STATEMENT OF ACCOUNT PLEASE
CONTACT 866- 782 -2355 EXT 56817
FEDERAL TAX ID# 26- 3683994
FOR SERVICE CALL 1- 800 -999 -9813
FREIGHT CHARGE: 0.00
GROSS AMOUNT: 176.40
INVOICE DISCOUNT: 0.00
NET AMOUNT: 176.40
TAX AMOUNT: 0.00
DOWN PAYMENT: 0.00
NET AMOUNT DUE: 176.40
INDIANA RETAIL TAX EXEMPT PAGE
C i ty of C armel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
r FEDERAL EXCISE TAX EXEMPT 2M
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL INDIANA 46032 -25$4 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
3 URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
MrAl
Sell Toehloglx Camol Police Department
VENDOR SHIP 3 Chic Square
P.O. DOU 73288 TO C9mDI, IN
Chicago, IL O 73 (317) 579 M
CONFIRMATION BLANKET CONTRACT PA YMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Ac4ou Its 42 .M
3 Each pamr adepter E $58.80 3178.40
Sub Total: $178.40
�rw i
Send Invoice To:fi
Cmmol Police Depar4mGM
Mtn. TeFosa Andomon
3 Civic squar2
Cannel, IN 46M- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
Carmel Felice Dept. PAYMENT $476.40
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 SUFFICIENT-TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. �hlcf ��ll��
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. J
DOCUMENT CONTROL N O. 2 3 00 CLERK- TREASURER
A.P.V. COPY ,,SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
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
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
Bell Techlogix
IN SUM OF
P.O. Box 73286
Chicago, IL 60673
$176.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
27300 299032 42- 390.99 $176.40_ 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, March 30, 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))
03/23/11 299032 payment for computer adapters $176.40
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