167168 12/17/2008 CITY OF CARMEL, INDIANA VENDOR: 00352967 Page 1 of 1
~f ONE CIVIC SQUARE ROBERTS DISTRIBUTORS, INC. CHECK AMOUNT: $192.09
CARMEL., INDIANA 46032 255 SOUTH MERIDIAN STREET
ti oM. INDIANAPOLIS IN 46225 CHECK NUMBER: 167168
CHECK DATE: 12/1712008
DEPARTMENT AC COUNT PO NU MBER I NUMBER AMOUNT DESCRIPTION
1110 4341901 51119723 X 29.15 FILM DEVELOPMENT
1110 4239099 18972 51119991 162.94xBATTEIRY /CHARGERS
5 r
ra 3
Invoice
Page: 1
ROBERTS' DISTRIBUTORS, LP Ticket 5- 1119991
12225 N. MERIDIAN ST. Ticket date: 12/10/08
CARMEL, IN 46032 Station: 503
317 -818 -9800 Fax 317 -818 -1400 FE-#32-0000112 Orig ord 5- 1119991
Sold to: CARMEL POLICE DEPT Ship to:
3 CIVIC SQUARE
CARMEL, IN 46032
317 571 -2500
Customer CAPD Ship date: Purchase Order 18972 Ship -via code:
Sis rep: 65 Location: 5 Terms: NET 30 DAYS
Quanta i#em�# Description Manuf Part-# Price ..Unit flag E>ct pre
tY
1 SYN- 00058A SYN -SDM -104 AC /DC CHARGER Fl CANON BP -945 24.97 EACH 24.97
1 CAN- 00727C CAN- VL -10LI Ii VIDEO LIGH 1729BODI 78.00 EACH 78.00
1 SYN -00009 SYN -BP -945 6000 MAH F/ CANON 59.97 EACH 59.97
1 NOTE attn: john elliot 0.00 EACH 0.00
AfrlOLin�.t
p
r"i ACCTS REC 162'.94
a s a A Total Charg 1.62'.94
1
Drawer: 503 User: 65 Total line items: 4 Sub Total: 162.94
Tax: 0
Total: 162.94
Tax: 0.00
Authorized Signature:
PLEASE PAY FROM THIS INVOICE
We Appreciate Your Business
Please REMIT to: 255 S. Me St., Indi IN 46225 TOTAL AMOUNT DUE: 162.94
INVOICE
Date printed: 12/10/08
ROBERTS' DISTRIBUTORS, LP Ticket 5- 1119723
12225 N. MERIDIAN ST. Ticket date: 12/9/08
CARMEL, IN 46032 Station: 503
317 818 -9800 Fax 317 818 -1400 FE-# 32- 0000112
Orig ord 5- 1119723
Sold to: CARMEL POLICE DEPT Ship to:
3 CIVIC SQUARE
CARMEL, IN 46032
317- 571 -2500
Customer CAPD Ship date: Purchase Order Ship -via code:
Sls rep: 42 Location: 5 Terms: NET 30 DAYS
Quantity:; Item #i De "scnption ;m Price Unit.flaa Extprc
5 CRM -00001 CRM -DEV ONLY C -41 351 2.24 EACH 11.20
5 CRM -00051 CRM -CD STANDARD, 1ST 159 EACH 17.95
Payments
ACCTS REC. .29.15
Total Charges: 29.15
Drawer: 503 User: 53 Total line items on ticket: 2 Sale subtotal: 29.15
Tax: 0.00
Authorized Signature.
PLEASE PAY FROM THIS INVOICE
We Appreciate Your Business
Please REMIT to: 255 S. Meridian St., Indianapolis, IN 462 25 TOTAL AMOUNT DUE 29.15
kUo: DISTRIBUTORS, LP
1222� N. MERIDIAN ST.
CARMEL IN 46032
317-818-9800
TlckE1# 5-1118723 User: 33
O/i� u[U 0 5-1119723
12/09/2008 12:26 p@ 3tdiiO0: 503
Tt8N x Oiy Price Total
Description
CRN-00001 5 2.24 11.20
C0N-OEV ONLY C-41 35/APS
CRN-00051 5 3.59 17.9
CRN-CD STANDARD. lST ROLL
3Ubt0 ta1 29.15
Tax 0.00
Total
Tender:
ACCTS REC 29.15
Order 5-1119723
Order total
Order amt duo
Number Of items purc 10
3ale8V8rSO0: 42
CARNEL POLICE DEPT
3 CIVIC SQUARE
CARNEL, IN 45032
317-571-2500
No Merchandise may be retUm61d .vd 14
days from UUta o[ Purcms8. A/
merchandise mUSL be in new Co/x1|| m^,
have original packaging and be returned
with blank warranty card-s. R8stOCk1OQ
f88 may apply.
INDIANA RETAIL TAX EXEMPT PAGE o f anal CERTIFICATE NO.003120155 002 0 1 f 1
C i t y ISJS PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35- 60000972 1 RQ7?
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
RObarttsCame2 a
VENDOR SHIP Carmel polio' !3epartment
T O 3 Civic Square
Carmml, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1 Cann LL10Cill 78.00 73.00
1 Canon Battery 60100 60.00
1 Charger 6090 60,00
Carmel Police Dep
Send Invoice To: A7My Teresa Anderson
3 Civic Square
Carmel, In 46032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
1110 390 -99 lab supplies PAYMENT 198.00
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
SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY {'��J /•9F)/" `YlY1/.(/I
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chi of C)f T)nl
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
18 9 CLERK- TREASURER
DOCUMENT CONTROL NO A.P. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
r
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
I
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
Roberts' Distributors Purchase Order No. 18972F
255 S. Meridian Street Terms
Indianaoplis, IN 46225 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1219108 51119723 a ent for film development 29.15
12110108 51119991 a ent for camera accessories 162.94
Total 192.09
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
Roberts' Distributors
IN SUM OF
255 S. Meridian Street
Indianaoplis, IN 46225
192.09
ON ACCOUNT OF APPROPRIATION FOR
police genera lfund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
18972F 51119991 390 -99 162.94 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
1110 51119723 419 -01 29.15 which charge is made were ordered and
received except
December 11 20 08
Signature
Chief of POlice
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund
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
i