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Home My WebLink About164649 10/16/2008 F CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1 ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $1,093.70 J, CARMEL, INDIANA 46032 7001 WOOSTER PIKE MEDINA OH 44256 CHECK NUMBER: 164649 CHECK DATE: 10/16/2008 DEPARTMENT ACCOUNT PO NUMBER IN NUMBER T AMOUNT DESCRIPTION 900 4359005 18953 108443 1,042.46 CAR SEATS 900 4359005.:.18953 108447 51.24 CAR SEATS �cKil sOu!' a Invoice Invoice Number: 0000108443 7001 Wooster Pike, Medina, OH 44256 Ph: 330.723.4739 Fax: 330.721.6799 Invoice Date: 9/29/2008 REMITTANCE ADDRESS: Invoice Due Date: 10/29/2008 WESTERN RESERVE DISTRIBUTING, INC. dba CHILD SOURCE Customer: CARMPD P.O. BOX 73714 Sales Order: 0000079644 CLEVELAND, OH 44193 L Tax ID #82- 0563593 Skid To s CARMEL POLICE DEPARTMENT, CITY CITY OF CARMEL POLICE DEPT 3 CIVIC SQUARE 3 CIVIC SQUARE CARMEL, IN 46032 -2584 USA ANN GALLAG14ER 317 -571 -2720 PO #18953 Carmel, IN 46032 USA Customer P O f Sh�p,yia.`•3� .s. 77T 18953 i FEDEX GRND ORIGIN Net 30 Days on ti� Unit�Price Ari�ount:E~ w a tv Sht eii 3292198 EXPRESS BOOSTER 2PK 30- 100# 2PK 4 51.250. 205.00 93- 209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 8 43.950: 351.60 93- 12OFSM SCEN.ERA 4 HNS POS (2/PK) 6 39.900 239.40 3321198 EVENFLO EMBRACE INFANT SEAT 2 59.750 1.19.50 LAST ITEM I i I I Tracking Numbers: 066443711247733, 066443711247740, 066443711247757, 066443711247764, 066443711247771, 066443711247788 ,066443711247795, 066443711247801, 066443711247818 ,066443711247825, 066443711247832 Subtotal 915.50 Freight 126.96 Sales Tax 0.00 Payment/Credit Amount 0.00 y]- •Balance 1,042,46 child source" Invoice Invoice Number: 0000108447 7001 Wooster Pike, Medina, OH 44256 Ph: 330.723.4739 Fax: 330.721.6799 Invoice Date: 9/29/2008 REMITTANCE ADDRESS: Invoice Due Date: 10/29/2008 WESTERN RESERVE DISTRIBUTING, INC. dba CHILD SOURCE Customer: CARMPD P.O. BOX 73714 Sales Order: 0000079644 CLEVELAND, OH 44193 y Tax ID 482- 0563593 Sold To CARMEL POLICE DEPARTMENT, CITY CITY OF CARMEL POLICE DEPT 3 CIVIC SQUARE 3 CIVIC SQUARE CARMEL, IN 46032 -2584 USA ANN GALLAGHER 317 571 -2720 PO 918953 Carmel, IN 46032 USA CUSTOI93CrP.0:`� a m�111 V13� FO.B' e: "'TCYTl]S ro rtzs ems. i 18953 i FEDEX GRND ORIGIN Net 30 Days 4045 1 80161568- LOCKING CLIP SILVER 30 1.500 45.00 i I AST ITEM I I i I I Tracking Numbers: 066443711247887 Subtotal 45.00 Freight 6.24 Sales Tax 0.00 Payment/Credit Amount 0.00 x 'Balance 51.24 I INDIANA RETAIL TAX EXEMPT PAGE C i t y of C l armel CERTIFICATE NO.003120155 002 0 1 \11' PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 1 R4 T 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 PATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION September 25, 008 car seats SHIP VENDOR Child Source City of Carmel Police Department 7001 Wooster Pike TO 3 Civic Squarew Medina, OH 44256 Carmel, IN 4601032 ATTN: Ann Gallagher (317) 571 -2.720 CONFIRMATION =ONIT PAYMENTTERM FREIGHT QUANTITY DESCRIPTION UNIT PRICE EXTENSION 4 3292198 Express Booster 2pk 30 -100# 51.25 205.00 8 93- 209FSM High Back booster front AD/'2pk 43.95 351.60 6 93 12OFSM Scenera 4 has pos 2pk 39.90 239.40 2 3321198 Evenflo Embrace Infant seat 59.75 119.50 30 4045 8@161568 Locking Clip si ver 1.50 45.00 shipping 133 �s n tr Z 4, mo 7 City of Carmel Pa Send Invoice To: ATTN; Teresa Anders 3 Civic Square Carmel, IN $6032 PLEASE INVOICE IN DUPLICATE 1,093.70 DEPARTMENT ACCOUNT PROJECT/ PROJECT ACCOUNT AMOUNT 900 590 -05 car seat ,grant 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. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. l' PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY l` ��•I. YL/r J/ ��ff fJ �I SHIPPING LABELS. 1 THIS ORDER ISSUED W COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Ch of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. Q q CLERK TREASURER DOCUMENT CONTROL NO. A. 4 COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO.— T 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 2,0 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. 18953F 7001 Wooster Pike Terms Medina, OH 44256 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 9'/29/08 108443 payment for car seats 1,042.46 9/29/08 108447 payment for locking clips 51.24 Total 1,093./70 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 C hild Source IN SUM OF 7001 Wooster Pike Mddina, OH 44256 1,093.70 ON ACCOUNT OF APPROPRIATION FOR police grant -fund Board Members Po# INVOICE NO. ACCT #/TITLE AMOUNT DEPT. a I hereby certify that the attached invoice(s), or 18953F 108443 590 -05 1,042.46 bill(s) is (are) true and correct and that the 18953F 108447 590 -05 51.24 materials or services itemized thereon for which charge is made were ordered and received except October 8 20 08 Signature chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund