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Home My WebLink About198503 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 097550 Page 1 of 1 ONE CIVIC SQUARE FITZCO INC CARMEL, INDIANA 46032 PO BOX 270107 CHECK AMOUNT: $917.50 MINNEAPOLIS MN 55427 CHECK NUMBER: 198503 CHECK DATE: 6122/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER A DESCRIPTION 1110 4239099 27821 43811 917.50 BARRIER POUCH Customer Copy FITZCO, INC PO BOX 270107 MINNEAPOLIS, MN 55427 PAGE 1 UNITED STATES OF AMERICA (952)- 224 -2700 INVOICE DATE 5/25/2011 INVOICE NO 43811 S 4CARMEL S CARMEL INDIANA POLICE DEPT 0 JOHN ELLIOTT H JOHN ELLIOTT L CARMEL INDIANA POLICE DEPT 1 3 CIVIC SQUARE D 3 CIVIC SQUARE P CARMEL,. IN 46032 CARMEL, IN 46032 T T 0 0 NET DUE 917.50 SL31 SLS2 DUE DATE DISC DUE DATE ORDER NO ORDER DATE SHIP DATE SHIP NO HS 6/24/2011 5/25/2011 00046326 5/6/2011 5/25/2011 1Z556E750345163577 TERMS DESCRIPTION CUSTOMER PO NUMBER SHIP VIA 0/0,n/30 JOHN ELLIOTT REQUEST UPS Ground ITEM ID TX CL UNIT ORDERED SHIPPED UNIT PRICE EXTENSION 21007 1 EACH 3,000.000 3,000.000 .3000 900.00 FITZPAK 4.5ML 6.5" X 9.5' EVID PCH Lot Number 116007 3,000.000 1% INTEREST PER MONTH ON PAST DUE INVOICES. TAXABLE NONTAXABLE FREIGHT SALES TAX MISC TOTAL 0.00 900.00 17.50 0.00 0.00 917.50 PRIOR INVOICES 0.00 PREPAYMENT 0.00 NET DUE 917.50 INDIANA RETAIL TAX EXEMPT PAGE Cit ®f C armel 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, 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 Fi42co, Inc. COMM Polies Department VENDOR SHIP 3 Civic Square 42-00 ShomIlno DrIvo TO Carmol, IN Opiing Par#, MN MM (317) 679 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREI h Accou =UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 42- 3 Each onier Pouch $300.00 $000.00 1 Eacv shipping $17.50 $17.50 Sub Total: $917.6017.50 y V d g as •o 4 Send Invoice To: f CarnOI Police B®paitment I 0 Attn: Teresa Anderson 3 Civic Squm Carmel, IN 46M- PLEASE INVOICE IN DUPLICATE DEPARTMENT n ACCOUNT PROJECT I PROJECT ACCOUNT PNOUNT C armel Police D ept. PAYMENT A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT HERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIAT4 �S FFICIENT TO PAY FOR THE ABOVE ORDER. SHIP REPAID. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. 4 ORDERED BY PURCHASE,ORDER NUMBER MUST APPEAR ON ALL .SHIPPING LABELS. hlo 7 o P oliere THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK TREASURER DOCUMENT CONTROL No.2782 1 A.P.V. COPY SIGN AND RETURN TO CLERK OFFICE VOUCHER WARRANT NO.,------ ALLOWED 20 |N THE SUM OF$ ON ACCOUNT OF APPROPRIAT FOR Board Members PO# or DEPT. INVOICE NO. ACCT#MTLE AMOUNT hereby certify that the attached invoima(a) biU/a\ is (are) true and correct and that the materials or services itemized thereon for which charge ia made were ordered and received except 20 omnmum �Title Cost distribution ledger classification if claim nom�pm�ve�mnmgxwxvfund 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)) 05/25/11 43811 payment for lab supplies $917.50 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Fitzco, Inc. IN SUM OF 4300 Shoreline Drive Spring Park, MN 55384 $917.50 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 27821 43811 42- 390.99 $917.50 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 Friday, June 17, 2011 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund