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Home My WebLink About198945 07/06/2011 CITY OF CARMEL, INDIANA VENDOR: 359589 Page 1 of 1 ONE CIVIC SQUARE CHAMPION CHRYSLER JEEP AND DOD CARMEL, INDIANA 46032 4505 W 96TH STREET SECK AMOUNT: $111.20 INDIANAPOLIS IN 46268 CHECK NUMBER: 198945 CHECK DATE: 7/6/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4237000 25783 63538 111.20 WINDSHIELD WIPER MODU PARTS INVOICE a 44107 JASON PENDING KOREY MILLER 06/20/11 63538 B 733 -4600 s CHR o� L O CARMEL PqLICE p 0 97G781143 3400 W CARMEL, 2584 DESCRIPTION 1 55077098 -AL MODULE wi 23067076 420A 174.2 111.2 111.2 PARTS RETURN POLICY ALL RETURNED PARTS MUST o CONFORM TO THE ORIGINAL PARTS PACKAGING QUALITY N STANDARDS, THOSE STANDARDS m SHOWN UPON REQUEST. NO REFUNDS ON SPECIAL ORDER 0 U PARTS OR ELECTRICAL PARTS: 2 rri ALL RETURNED PARTS SUBJECT w TO 20% RESTOCKING CHARGE: 0 w U SUBTOTAL 111.2 DISCLAIMER OF WARRANTIES o Any warranties on the item/items sold hereby are those made by the manufacturer. the seller, CHAMPION CHRYSLER JEEP DODGE, hereby expressly disclaims all warranties, either express or implied, including any TAX implied warranty of merchantability or fitness for a particular purpose, and CHAMPION CHRYSLER JEEP DODGE neither assumes nor authorizes any other person to assume for it any liability in connection with the sale of the iteWitems. FREIGH 0.0 PAY THIS AMOUNT 8.9 a` CUSTOMER SIGNATURE X CUSTOMER COPY NOBODY BEATS A 4505 W. 96th Street 07:16:23 PAGE 1 OF 1 :C HAMPION Indianapolis, IN 46268 NET504 (317) 872 -6200 (877) 931 -6200 CHRYSLER Jeep www.championcjd.com City C�� INDIANA RETAIL TAX EXEMPT PAGE Jl r CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 25 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 f�9 9 Chmmplon ChrWlGP ,loop Dodge CIlllm PoIICG DGpartmGnt VENDOR SHIP 3 CIVIC squm der W. Mh Str°GIA TO Carm IN dM lndlalcipolls, IN 4M (397) 699 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT A ccount OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 42.3 gp 0,00 1 Each windshield wiper module $111.20 4911.20 Bub Total: $991.20 p A r Send Invoice To: feel Pollce DepRomeng Attn: Tomsm Andorson 3 C IVIC squm cum®I, IN 4032- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT mrmel Police Dept. PAYMENT SM.20 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 SHIP REPAID. THIS APPROA I -ION SUFFICIENT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY /f/ PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. daFn hlG� i ®II�i� THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE V AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK TREASURER i0CUME CONTROL NO- 25783 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. 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 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)) 06/20/11 63538 payment for repair parts $111.20 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 Champion Chrysler Jeep Dodge IN SUM OF 4505 W. 96th Street Indianapolis, IN 46268 $111.20 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 25783 I 63538 I 42- 370.00 I $111.20 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 Wednesday, June 29, 2011 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund