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167191 12/17/2008 CITY OF CARMEL, INDIANA VENDOR: 354377 Page 1 of 1 ONE CIVIC SQUARE U.S. UNIFORM SUPPLY INC CHECK AMOUNT: $2,026.84 CARMEL, INDIANA 46032 815 N DELAWARE ST INDIANAPOLIS IN 46204 CHECK NUMBER: 167191 CHECK DATE: 12/1712008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION 1110 4356001 41411 2,026.84 UNIFORMS e CITY OF CARMEL, INDIANA VENDOR: 354377 Page 1 of 1 ONE CIVIC SQUARE U.S. UNIFORM SUPPLY INC INDIANA 46032 815 N DELAWARE ST CHECK AMOUNT: $2,026.84 CARMEL INDIANAPOLIS IN 46204 CHECK NUMBER: 167191 CHECK DATE: 12117/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBE AMOUNT DESCRIP 1110 4356001 41411 2,026.84 UNIFORMS t. c= US UNIFORM SUPPLY Invoice 815 N. Delaware St. Indianapolis, IN 46204 Transaction 41411 317 822 -8166 Account CARMEL 317 822 -8167 Page: 1 of 3 Date: 12/1/2008 Time: 3:53:20 PM Cashier: 6 Register 2 Bill To: ACCOUNTS PAYABLE Ship To: STORE ORDER CARMEL POLICE DEPARTMENT DEPARTMENTAL BILLING 3 CIVIC SQUARE CARMEL, IN 46032 317.571.2500 Des`c_n ti on Quantit Pnce Extended. Rep ;Item Lookup Code p y �K.m „A LB p 610737281575 ELBECO SHIRT Z314 NVY 16/34 3 $51 P95 $155.85 LEAVE PLASTIC BUTTONS LB 610737130309 ELBECO SHIRT Z3314 NAVY 15.5 3 $49.95 $149.85 LEAVE PLASTIC BUTTONS LB 610738263533 ELBECO PANT E8875R NAVY 33 3 $69.95 $209.85 NANODRY CARGO LB 001ACASP PATCH CARMEL PD SHOULDER 14 $1.50 $21.00 6 SHIRTS/ 1 JACKET LB 48017 5.11 JACKET 5 IN 1 1 $259.99 $259.99 SIZE: LARGE COLOR: NAVY LB 001 PH PANT HEMMING 3 $4.00 $12.00 LB 001INS PANT INSEAM 3 $0.00 $0.00 LB 010TIE TIE 2 $9.75 $19.50 LB 5546 -3 BOSTON 5546 -3 BKBW -S LT RING 1 $22.95 $22.95 LB 781602057486 SAF 77 -83 -4 DBL MAG BKBW 1 $38.95 $38.95 LB 781602047302 SAF 334V GLOVECASE BKBW 1 $19.95 $19.95 LB 801NO73533 PEERLESS HANDCUFF 801 1 $48.95 $48.95 LB 781606967101 SAF 190 -2 -4 HANDCUFF CSE ASP 1 $34.95 $34.95 LB 092608526334 ASP HOLDER BLKBW F262633 1 $34.95 $34.95 LB 092608526112 ASP BATON "26" BLK CHROME 1 $81.95 $81.95 SHFT LB 781602613545 SAF BELTKEEPER 4 PACK 1 $14.95 $14.95 LB BOSTONBELTBLKBW BOSTON BELT BLACK BW 1 $27.95 $27.95 LB 78160206480 SAF 87 -36 -8 DUTYBELT BKBW 36 1 $69.95 $69.95 Continued on next page... US UNIFORM SUPPLY Invoice 815 N. Delaware St. Indianapolis, IN 46204 Transaction 41411 317 822 -8166 Account CARMEL 317 822 -8167 Page: 2 of 3 Date: 12/1/2008 Time: 3:53:20 PM Cashier: 6 Register 2 Bill To: ACCOUNTS PAYABLE Ship To: STORE ORDER CARMEL POLICE DEPARTMENT DEPARTMENTAL BILLING 3 CIVIC SQUARE CARMEL, IN 46032 317.571.2500 I Rep Item Lookup Code y Description Quantity g �Extended:r LB 59012 POLICE GEAR BAG 1 $39.95 $39.95 LB BLAUERJ733 BLAUER RAIN JACKET 733R 1 $165.95 $165.95 ALL COLORS ADD XXL /$20 XXXL /$30 LB TH0831 -6031 THOROGOOD 831 -6031 1 $69.95 $69.95 10W LB DANNER42908 DANNER BOOT 42908 STRIKER 8" 1 $159.95 $159.95 10.5EE LB DCIN DICKIES COVERALLS NAVY 1 $89.95 $89.95 INSLTD SIZE LARGE LB PB- TTS43 -CA POSSE PB -TTS43 FORM HOLDER 1 $29.95 $29.95 4.5" x 10.75' CHROME LB 044357100174 SA- 10017, A -FRAME REPORT 1 $31.95 $31.95 HLDR LB 038739080024 MAGLITE TRAFFIC WAND 1 $9.95 $9.95 FOR MAG LITE LB MAG3D MAGLITE 3 D -CELL NOW 1 $44.95 $44.95 RECHARGE SPECIAL ORDER ONLY LB HATCHGDNR100 HATCH GLOVE DNR100 1 $39.95 $39.95 SIZE MEDIUM LB BAYLY HAT BAYLY DRESS POLICE HAT 1 $59.95 $59.95 SIZE MEDIUM Continued on next page... W 10=77510 US UNIFORM SUPPLY Invoice 815 N. Delaware St. Indianapolis, IN 46204 Transaction 41411 317 822 -8166 Account CARMEL 317 822 -8167 Page: 3 of 3 Date: 12/1/2008 Time: 3:53:20 PM Cashier: 6 Register 2 i Bill To: ACCOUNTS PAYABLE Ship To: STORE ORDER CARMEL POLICE DEPARTMENT DEPARTMENTAL BILLING 3 CIVIC SQUARE CARMEL, IN 46032 317.571.2500 Reps ta Item Lookup Code Descnpfion ty P Extended f LB 095BAYLYBAND BAYLY HAT BAND 1 $11.95 $11.95 LB BAYLYRAINCVR BAYLY HAT RAIN COVER 1 $11.95 $11.95 LB BLAUERTROPN BLAUER TROOPER CAP NAVY 1 $36.95 $36.95 iMA a Sub Total $2,026.84 Thank you for shopping Sales Tax $0.00 0 Total $2,026.84 Please come again! Store Account $2,026.84 Change Due $0.00 41411 INDIANA RETAIL TAX EXEMPT PAGE C i t y ®11 C rmel CERTIFICATE NO.003120155 002 0 1 f 1 of CSJS Jlli PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 18987 3. 0_'KIE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL,tINDIANA 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 December 2, 2008 uniforms accessories VENDOR US Uniform Supply SHIP City of Carmel Police Department 815 N. Delaware Street TO 3 Civic Sgqare Indianapolis, IN 46204 Carmel, IN 46032 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION uniforma/ accessories for Officer Greg Loseall 2,026.84 m Send Invoice To: PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT 1110 560 -01 uniforms 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 THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. SHIP REPAID. 1 C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY 1.1: //fl' PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. I 8 A 8T CLERK TREASURER DOCUMENT CONTROL NO A. 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. 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 Prescribed 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 US Uniform Supply Purchase Order No. 18987F 815 N. Delaware Street Terms Indianapoils, IN 46204 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 12/1/08 414& payment for uniforms accessories for Officer Greg 2 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 U UNiform SUpply IN SUM OF 815 N. Delaware Street Indianapoils, IN 46204 2,026.84 ON ACCOUNT OF APPROPRIATION FOR police g eneral fund Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 18987F 41411 560 01 2,026.84 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 December 11 20 08 -b Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund