197366 05/11/2011 CITY OF CARMEL, INDIANA VENDOR: 363645 Page 1 of 1
ONE CIVIC SQUARE RIMAGE CORPORATION
CHECK AMOUNT: $1,370.68
CARMEL, INDIANA 46032 Nw5255
PO BOX 1450 CHECK NUMBER: 197366
MINNEAPOLIS MN 55485 -5255
CHECK DATE: 5/11/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4230200 27777 90081599 1,370.68 MEDIA KIT
Page 1 of 1
Phone: 1- 800 -445 -8288 04/21/2011 22:02:07
Fax: 952 -944 -7808
R I M A G E T" Internet: www.rimage.com
Invoice
Sold .To Party InforMatlon
CITY OF CARMEL POLICE DEPT. Invoice Number /Date 90081 599 04/21/2011
3 CIVIC SQUARE Delivery Number /Date 801 19308 04/21/2011
CARMEL IN 46032 Sales Order Number /Date 10044606 04121/2011
USA PO Number 27777
PO Date 04/21/2011
Customer No. 120998
Ship -To Party Invoice Amt 1,370.68 USD
CITY OF CARMEL POLICE DEPT. Term of Payment Net due in 30 days
3 CIVIC SQUARE Incoterm FOB DESTINATION
CARMEL IN 46032 Gross Weight 90.000 LB
USA Carrier UPS Parcel Tracking
Bill of Lading I Z5W1 9X80310214128
Rimage Contact Tracey Dietsch
Customer Contact: GREG MILLER
Item Material/Description Quantity Unit Price Value
10 210843 -003 2 EA 685.34 1,370.68
Media Kit EIII, 1000 White DVD (CMY)
Subtotal 1 370.68
Drop Ship 0.00
Freight 0.00
Tax 0.00
Total Invoice Amount 1,370.68
>f'
;Wells Fargo Bank, N.A. Please Remit Payment to
Minneapolis, MN Account 4100163674 Rimage Corporation
:ABA Routing 121000248 S.W.I.F.T. WFBIUS6S NW5255 PO Box 1450
`Federal ID 41- 1577970 Minneapolis, MN 55485 -5255
DUNS# 15- 177- 2530
Thank you for your business.
Freight Charges include taxes, duties and brokerage fees which are not refundable in the event of a return. Rimage
reserves the right to send a supplemental invoice for additional freight expenses incurred after the actual ship date.
INDIANA RETAIL TAX EXEMPT PAGE
C ity of Carmel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
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
411 W20i i
Glimago Corporation CwmoI Police DoWwont
VENDOR
SHIP 3 Civic 9quam
7M Waohington Avonua Sm Ah TO Carmol, IN 46M
Hinnompolls, IAN 56M (317) 671
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42 -M2.0
2 Each Rimage Mediae Kit DIVED $685.34 $9.3 70.68
Sub Total: al: I,310.68
tp r
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a g?y
Send Invoice To:
Carmcai Police Department
Attn: Toms& Anderson
3 Civic squ
Carmol, IN PLEASE INVOICE IN DUPLICATE
DEPARTMENT A COUN PROJECT PROJECT ACCOUNT AMOUNT
Carmel Policy Dept. asp,
PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE P�//RR�p ET RE AFFIDAVIT ATTACHED.
A SHIPPING INSTRUCTIONS HEREBY CERTIFY FTA HERE IS AN UNOBL!G T,ED�BALANGE IN
SHIP REPAID.
THIS APPROPRI ON U iCIENT TOP FOR THE ABOVE ORDER.
C -O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY ��ay y�
SHIPPING LABELS. Ch of Pollc
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE V
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
t
DOCUMENT CONTROL No. 277 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO- WARRANT NO.
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #(TITLE AMOUNT
D EPT. I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except_
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
Rimage Corporation ALLOWED 20
NV '?o 6x &S -C' IN SUM OF
Minneapolis, MN ii439 5 4,Y5 S�$S
$1,3
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO, ACCT #ITITLE AMOUNT Board Members
27777 90081599 42 302.00 $1,370.68 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 a 05, 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))
04/21/11 90081599 payment for DVD's $1,370.68
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