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HomeMy WebLinkAbout166157 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1 ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $1,341.25 CARMEL, INDIANA 46032 7001 WOOSTER PIKE o� MEDINA OH 44256 CHECK NUMBER: 166157 CHECK DATE: 11/24/2008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 900 4359005 18975 111447 1,341.25 CAR SEATS rc -ild Invoice chi6c! sources' Invoice Number: 000011.1447 7001 Wooster Pike, Medina, OH. 44256 Ph: 330.723.4739 Fax: 330.721.6799 Invoice Date: 11/7/2008 REMITTANCE ADDRESS: Invoice Due Date: 12/7/2008 WESTERN RESERVE DISTRIBUTING, INC. dba CHILD SOURCE Customer: CARMPD P.O. BOX 73714 Sales Order: 0000080534 CLEVELAND, OH 44193 Tax ID 482- 0563593 Ship To CARMEL POLICE DEPARTMENT, CITY OUR LADY OF MT CARMEL 3 CIVIC SQUARE 1045 W 146TH STREETE CCARMEL, IN 46032 -2584 USA MAGGIE 317 -819 -0733 Carmel, IN 46032 USA 18975 FEDEX GRND ORIGIN Net 30 Days Item Ma' Description E,.t Q tv,Shii b d; Unit Priceµ Amb unt a 3321198 EVENFLO EMBRACE INFANT SEAT 5 59.750 298.75 SHIP FED EX MULTIWEIGHT 93- 12OFSM SCENERA 4 HNS POS (2/PK) 39.900 319.20 93- 209FSM HIGH BACK BOOSTER FRONT ADJ 2 PK 10 43.950 439.50 93- 299FSM BACKLESS SHIELDLESS BOOSTER (4 PER PACK) 8 14.750 118.00 LAST ITEM -1 i 1 i 1 i I j l Tracking Numbers: 066443711301534, 066443711301541, 066443711301558, 066443711301565, 066443711301572, 066443711301589 ,066443711301596, 066443711301602, 066443711301619 ,066443711301626, 066443711301633 ,066443711301640, 066443711301657, 066443711301664,066443711301671 Subtotal 1,175.45 Freight 165.80 Sales Tax 0.00 Payment/Credit Amount 0.00 £Balance 1,341.25 c INDIANA RETAIL TAX EXEMPT PAGE iq Car CERTIFICATE NO. 003120155 002 0 PURCHASE O DER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 1. 35- 60000972 189 3 ©N CIVIC SQUARE FHISN BER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA 46032 -2584 DELIVERY MEMO, PACKING SLIPS, 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 November 4. 2008 car seats VENDOR Child Source SHIP Our Lady of Mt Carmel Trinity Clinic 7001 Wooster Pike TO 1045 W. 146th Street Medina, OH 44256 Carmel, IN 46032 ATTN: Maggie 317 -819 -0773 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION 5 3321198 Evenflo Embrace Infant seat 59.75 298.75 8 93- 12OFSH Scenera 4 Hns pos 39.90 319.20 10 93- 209FSM High back booster front ad,j 43.95 439.50 4 90- 299FSM Backless shik &dless booster 14.75 118.00 shipping 165.80 a o, g City of Carmel PAI Send invoice To: ATTN: Teresa Anders 3 Civic Square Carmel, IN 46032 PLEASE INVOICE IN DUPLICATE 1,341.25 DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT 900 590• -05 car seat 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. h xl'o C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. 4 THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, 1945 TITLE Chief o f Police a AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. z7 ,j CLERK TREASURER D DOCUMENT CONTROL NO. A.P.5. COPY SIGN AND RETURN TO CLERIC'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. {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 Child Source Purchase Order No. 18975F 7001 Wooster Pike Terms Medina; OH 44256 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 11/7/08 111447 payment for car seats 25 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 C Hild Source IN SUM OF 7001 Wooster Pike Medina, OH 44256 1,341.25 ON ACCOUNT OF APPROPRIATION FOR p olice grant" fund Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 18975F 111447 590 -05 1,341. 5 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 November 18 20 08 Signature Cbiaf of P011re Cost distribution ledger classification if Title claim paid motor vehicle highway fund