199696 07/20/2011 CITY OF CARMEL, INDIANA VENDOR: 361937 Page 1 of 1
ONE CIVIC SQUARE T B A NORTH
I CHECK AMOUNT: $363.31
CARMEL, INDIANA 46032 309 CRADLE DRIVE
�ltin i� CARMEL IN 46032 CHECK NUMBER: 199696
CHECK DATE: 7/20/2011
DEPARTMEN ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4237000 25792 3JW8515 363.31 A/C COMPRESSOR
TBA North Invoice
309 Gradle Dr. N O. 03JW8515
Carmel, IN 46032
is 317 -574 -1957 FAX: 317- 574 -1982
Page 1
09:38:09 Jul 07 201 1
CUSTOMER NUMBER IATE PACKING SLIP __TERMS_. .�WHSb 318 51 11 03RH 1950001 NET 10TH 030
BILL T0: SHIPPED TO`.
CARMEL POLICE CITY GARAGE CARMEL POLICE CITY GARAGE
3 CIVIC SQUARE 3400 W 131ST
CARMEL, IN 46032 CARMEL, IN, 46074
11 IIIIII�i1'Ii6116L1U 11 IIIllilllll,IIIIIIIIIIIIIII�II
Dept: 002 CARMEL POLICE CITY GARAGE Contact: /317- 733 -4600 route: CARMEL /WESTFIEii D Direction:
YOUR PO. .NUMBER ORDER DATE CSR SHIPPED VIA CARTONS OPER
CAR 51 07/07/11, 09:38:05 200003 MATT SEGERSON 3 CARMEL /WESTFIELD A 202
ITEM DESCRIPTION BIN UNIT ORDER BACK INV LIST CORE NET NET EXT
OTY ORDERED QTY PRICE PRICE PRICE CORE PRICE
iVISS MOUNTAINDEW matdew NONE EA 1 0:;:;; 1 0.00 0.00 N/C 0.00 0.00;
2006 CHEVROLET IMPALA V6 -237 3.9L
D 1 15- 21471 89019271 COMPRESSOR KIT -A U EA 0 0 l 681.62 0.00 363.31 0.00 363.31
TX: 010
1
TOTAL PURCHASE TOTAL LIST TOTAL MDSE TOTAL CORE FREIGHT TAX PCT TAX AMT 3NVOiCE TOTAL PAYMENTS BALANCE DUE
363.31 681.62 363.31 0.00 0.00 0.00 363.31 0.00 363.31
2.08% service charge on past due accounts(25 per ann..um).
Core returns must be in original box. All new returns must
be resaleable. No return after 30 days without invoice.
Ci ,Jlr J� Carmel INDIANA RETAIL TAX EXEMPT PAGE
CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
a FEDERAL EXCISE TAX EXEMPT 25
a 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
TBA North Caninoi Police Depaftent
VENDOR SHIP 3 Civic Squam
SM Grmdlo Ddvo TO Camel, IN
Cumal, IN 46M
CONFIRMATION BLANKET CONTRACT PAYM T ERMS FREIGHT
i
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-370.00
9 Each A/C compmssor $363.39 $363.39
A Sub Total: $363.39
Z
4. r
,I
wr t ars�
Send Invoice To:
Cumol Police Depadment
Attu: Toros Andefuon
3 Civic Rqum
CUMGI, IN 2° PLEASE INVOICE IN DUPLICATE
DEPARTMENT S ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cannel Police D ept. PAYMENT x'39
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 AFFIDAWTATTACHED,
SHIPPING INSTRUCTIONS I HEREBY CERTIF�� THAT THERE IS AN UNOBLIGATED BALANCE IN
SNIP REPAID.
THIS APPROPR!1ATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. 1
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE I10 of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 2 5 7 92 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFfCE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PL?# 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
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))
07/07/11 3JW8515 payment for repair parts $363.31
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
TBA North
IN SUM OF
309 Gradle Drive
Carmel, IN 46032
$363.31
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Members
25792 I 3JW8515 I 42- 370.00 I $363.31 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
Thursday, July 14, 2011
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund