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HomeMy WebLinkAbout197127 05/11/2011 CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1 0 f ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $1,962.20 CARMEL, INDIANA 46032 7001 WOOSTER PIKE MEDINAOH 44256 CHECK NUMBER: 197127 CHECK DATE: 5/1112011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTI 900 4359005 27792 171845 1,962.20 BOOSTERS /CAR SEATS r c� ikd rce Invoice INAMMAI Invoice Number: 0000171845 7001 Wooster Pike, Medina, 0I -1 44256 Ph: 330.723.4739 Far: 330.721.6799 Invoice Date: 4/26/2011 REMI "I ANCE ADDRESS: Invoice Due Date: 5/26/2011 WESTERN RESERVE DISTRIBUTING. INC. Customer: GARMPD dba CHILD SOURCE' P.O. BOX 73714 Sales Order: 0000100155 CLEVELAND, 01 -1 44193 "Fax ID #82- 0563593 Sold To 7 Ship To CARMEL POLICE DEPARTMENT, CITY CARMEL POLICE DEPARTMENT 3 CIVIC SQUARE 3 CIVIC SQUARE CARMEL, IN 46032 -2584 USA ATTN ANN GALLAGHER 317 -5871 -2720 Cannel, IN 46032 USA Gusto-mer Termfi 27792 LTL -ESTES ORIGIN Net 30 Days Item Descri Q ty Shipped "Unit Price A mpuitt• ICO34AOB SAFETY Ist DESIGNER CARSLAT 5 -22i W /BASE 9 63.9000 575.10 (NORDICA) 93 12OFSM SCEN1 4 HNS POS (2 /PK) 10 S 43.0000 S 430.00 93- 209FSM HIGH BACK BOOSTER FRONT ADJ 21 10 S 47.2000 S 472.00 93-211 FSM VOYAGER HIGHBACK (2 PER PACK) 6 28.9000 173.40 93- 2991-SM BACKLESS SHIELDLESS BOOSTER (4 PER PACK) 4 14.9000: 59.60 LAST I'T'EM Tracking Numbers: 155- 1303972 Subtotal 1,710.10 LIFT GATE AND INSIDE_ Freight 2-52.10 Sales Tax 0.00 Payment /Credit Amount 0.00 r u °Balance 1.962.20 INDIANA RETAIL TAX EXEMPT PAGE C 1� oCERTIFICATE NO. 003120155 002'0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT znI 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. PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION Child Soured C2rmol Polka Mpart ono VENDOR SHIP 3 Ci Squmm Mi Woos$0r Pllse T O 01911 IN 46 NOdirrda, OH 44 (317) 67i -25 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT OUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account (M i .fir 1 Each shipping $252.90 $252.90 4 Each Hackies$ Shieidless B ooste r 03- 200FSM $94.90 $50.00 0 Each !lager l°lighba ck 93-211 FSM $26.00 173.4 0 10 Each High Back Booster Front A4j 3 F $47.2 $4672.0 90 Each Scones 4 HN POS r I 3�a2o 4 $43.00 $430.00 0 Each So 9 se Designer Cor Sezlv I N B $63. 90 $575.10 Sub Total: $9,062,20 A, fi cK V aclelf JA' Q k� bT 'Sk Send Invoice To: Carmel Pollce Depaitmont Attn- Tomsm Anderson 3 Civic Square C @mel, IN PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dept. X51 .z PAYMENT 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 CERTI �T�FI�TTHERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPR ON /SUFFICIENT TO PAY FOR THE ABOVE ORDER. f/ I Y C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY g SHIPPING LABELS. ia? of 6 pollc„o THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK TREASURER DOCUMENT CONTROL NO. 2 7 7 92 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 PD# or INVOICE NO. ACCT #(TITLE AMOUNT aEPT. 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 if claim paid motor vehicle higkway fund VOUCHER NO. WARRANT NO. ALLOWED 20 Child Source IN SUM OF 7001 Wooster Pike Medina, OH 44256 1, 96 2.2 0 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Grant Fund PO# I Dept. INVOICE NO ACCT /TITLE AMOUNT Board Members 27792 171845 590.05 $1,962.20 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, May 05, 2011 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by Slate 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)) 04/26/11 171845 payment for car seats $1,962.20 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