155184 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 00351912 Page 1 of 1
ONE CIVIC SQUARE AMERICAN RECORDABLE MEDIA INC
V44 WILLOW RIDGE ROAD CHECK AMOUNT: $670.00
CARMEL, INDIANA 46032 LEXINGTON KY 40514 CHECK NUMBER: 155184
M��tin �o
CHECK DATE: 1/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4230200 17313 212021 670.00 VHS TAPES
AMEERICAN
American Recordable Media Invoice
3744 Willow Ridge Road
g Date: Invoice
Lexington, KY 40514
800- 598 -8273 12/20/2007 212021
859- 296 -4737 fax
RECORDABILE
Bill to Customer 16145
ROBERT ROBINSON PO 17313
CARMEL POLICE DEPARTMENT TERMS: NET 30
3 CIVIC SQ Salesman: DAN CASE
C ARMEL, IN 46032 -2584 Shipped via: UPS
Item Description Price Amount
I HQ T -120 VHS FUJI HQ VHS, 120 MIN. 10 /CASE 500 $1.340 $670.00
Subtotal: $670.00
Sales Tax: $0.00
Shipping Handling: $0.00
I
INVOICE TOTAL: $670.00 I
PAID: No PAYMENT DATE: Amount Paid: $0.00
Thank You For The Order!! PAY THIS AMOUNT $670.00
I i
Note Finance Charges Of 1.5% Per Month Will Be Assessed On All Past Due Balances.
INDIANA RETAIL TAX EXEMPT PAGE
Ci o Carmel CERTIFICATE NO. 003120155 002 0 JL PURCHASE ORDER NUMBER
Police Dopartment FEDERAL EXCISE TAX EXEMPT
35- 60000972 1 7'i t
3 �ONEKCIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
January 4 200 3 VHS tapes
VENDOR American Recordable MEdia SHIP City of Carmel Police Department
3744 Willow Ridge Road TO 3 Civic Squane
Lexington, KY 40514 Carmel., IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
500 Fuji VHS tapes 1.34 670.00
f
y
I
Send Invoice To:
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
11.10 302 office supplies PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
1 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
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL I r
SHIPPING LABELS. AssiBtv.Pt Chief. of Police
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE !7
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO.1 313 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. 1 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
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
American Recordable Media Purchase Order No. 17313F
3744 Willow Ridge Road Terms
Lexington, KY 40514 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12120/0 212021 payment for VHS tapes 670.00
Total
I 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
VOUCHER NO. WARRANT NO.
ALLOWED 20
_Zmar;ra„ RPrnr*dAh1e'ZPdin IN SUM OF
3744 Willow Ridge Road
Lexington, KY 40514
670 00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
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
Januar 4 20 08
Signature
Acting Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund