155238 01/10/2008 ,a CITY OF CARMEL, INDIANA VENDOR: 048100 Page 1 of 1
ONE CIVIC SQUARE CARMEL PRO PRINTER CHECK AMOUNT: $692.01
i•.
�o CARMEL, INDIANA 46032 303 WEST CARMEL DRIVE
CARMEL IN 46032 CHECK NUMBER: 155238
CHECK DATE: 1/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 R4230000 17308 25989 692.01 OVERTIME VOUCHERS
!1
C? INVOICE
C'ARMEL PRO PRINTER Invoice 00025898
303 West Carmel Drive
Carmel, IN 46032 Date: 12/27/07
317 844 -9171
Your Order Robert
Bill To:
Carmel Police Department Ship To:
Attn: Accounts Payable
3 Civic Square Carmel Police Department
Carmel, IN 46032 3 Civic Square
Carmel, IN 46032
_Description Amount
6,500 "Overtime Voucher/ Time Off Request" Forms $692.01
Stock: 3 Part NCR w/ Black Ink 5.5 x 8.5
Thank You For Your Continued Business!
Terms: Net 30
Subtotal: $692.01
1.75% per month added to accounts over 30 days. Sales Tax: $0.00
If Carmel Pro Printer is required to resort to collection proceedings to recover fees
incurred and expenses advanced on customers (your) behalf, Carmel Pro Printer shall Freight: $0.00
also be entitled to recover all costs incurred in connection with such collection
proceedings including reasonable attomeys' fees incurred. Balance Due: $692.01
INDIANA RETAIL TAX EXEMPT PAGE
City o I' Carmel
CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
Poilice Department FEDERAL EXCISE TAX EXEMPT
f 35- 60000972 1 71(1
3 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
VENDOR Earmel Pro Printers TOIP City of Carmel Police Department
303 W. Carmel.Dr.ive 3 Civic Square
Carmel, IN 46032 Carmel., IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
overtime vouchers 692,01
E�
e
m
Send Invoice To:`
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 300 official farms 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
SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
f
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
7A r �.Ff• L l CC���fff���
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Ch 4 e F• o'F P,a)11 Adp
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO.1 .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 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
Carmel PRo Printer Purchase Order No. 17308RF
303 West Carmel DRive Terms
Carmel, IN 46032 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
19/97/07 25998. for.over-time youcliers 692.01
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
Car6pl Pro `Printer IN SUM OF
303 W. Carmel Drive
Carmel, IN $6032
692.01
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
17108BE 25q89 300 692.01 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
Acting Chief of POlice
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund