156571 02/21/2008 CITY OF CARMEL, INDIANA VENDOR: 355678 Page 1 of 1
ONE CIVIC SQUARE EMBLEMS INC
CARMEL. INDIANA 46032 PO BOX 8713
CHECK AMOUNT: $365.40
nSHFViLLE NC 28814 CHECK NUMBER: 156571
CHECK DATE: 2/2112008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4356002 17327 5176 365.40 CHEVRONS
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Invoice
THE EMBLEM
AMORITY
Date Invoice
2/4/2008 S 17G
P.O. Box 8713 Asheville. NC
28814
Bill To Ship To
Carmel Police Dept. Carmel Police Dept.
Attn: Teresa Anderson Attn: Michael Fogarty
3 Civic Square 3 Civic Square
Carmel, IN 46032 Carmel, IN 46032
S.Q. P.O. Terms Rep Ship Date Ship Via FOB
4176 17327 Net 30 CP 2/4/2008 tips Asheville
Item Description Quantity Price Each Ordered Amount
131304 Carmel Police Sergeant Chevron 522 0.70 500 365.40T
Out -of -state sale. exempt from 0.00% 0.00
sales tax
E -mail Web Site
Total $365.40
stacy a cmblemsinc.com www.thecmblemauthority.com
Payments/Credits $0.00
Phone Fax
800- 378 0417 888- 438 -4170 Total Amount Due $365.40
PAGE
s INDIANA RETAIL TAX EXEMPT
CERTIFICATE NO. 003120155 002 0 r
C arm PURCHASE ORDER NUMBER
it 1
Police Department FEDERAL EXCISE TAX EXEMPT
35- _60000972 17327
3 ]gHEXCIVIC 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 16, 2008 chevrons
VENDOR
The Emblpm Authority SHIP City of Carmel Police Department
P.O. Pox 8713 TO 3 Civic Square
Asheville, NC 28814 Carmel., IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
500 Sergeant Chevrons .70 360.00
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it
0
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Send Invoice To: City of Carmel Polic
ATTN: Teresa Anderson
3 Civic Square
Cammikk, IN 46032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT T PROJECT ACCOUNT AMOUNT
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1110 560 -02 uniform accessotie PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
I 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 ISAN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. f,Gc� t j
ORDERED BY
•PURCHASE ORDER. NUMBER MUST APPEAR ON ALL
11 t�Lc,
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chie o Pol ice
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO. 3 2 7A.RV. 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 #MTLE 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
Ttle
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Pre by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
The Emblem Authbroity Purchase Order No. 17327F
P.O.Box 8713 Terms
Asheville, NC 28814 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
2/4/08 1 5176 a ent for Sergeant chevrons 365.40
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
%i� n blem Authority
IN SUM OF
P.O. Box 8713
Asheville, NC 28814
365.40
ON ACCOUNT OF APPROPRIATION FOR
po lic e ge neral f
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
17327F 5176 560 02 365.40 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
February 12 20 08
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund