200640 08/17/2011 CITY OF CARMEL, INDIANA VENDOR: 294500 Page 1 of 1
s z. ONE CIVIC SQUARE STEVEN R JENKINS CO INC CHECK AMOUNT: $1,000.00
CARMEL, INDIANA 46032 6680E 21ST. STREET
INDIANAPOLIS IN 46219 CHECK NUMBER: 200640
CHECK DATE: 8/1712011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 R4356002 27117 165124 1,000.00 HOLTSERS
09/11/2008 05:03 3173520185 STEVEN R JENKINS CO PAGE 02/02
STEVEN R JENKINS CO 1NC Invoice
6680 E 21ST ST pate nvoice
INDLANAPOLIS IN 46219
1- 317- 352 -0184 �l0�zo11 16s lza
Bill To Ship To
CARTEL POLICE DEFT
3 CIVIC SQUARE
CARMEL, IN 46032
P.O. Number Terms Rep
27117 JGL
Quant. Item Code Description Price Each Amount
10 40000 GEN... G G BOLSTERS 100.00 1,000.00
Sales Tax 0.00% 0.00
SHOP 1,000.00
P sr jco corn Total
INDIANA RETAIL TAX EXEMPT PAGE 1 C o` o 1
Carmel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
or
Police Department FEDERAL EXCISE TAX EXEMPT 27117
35- 60000972
30NRhK CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, AIP
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
DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO, VENDOR NO, DESCRIPTION
December 16, 2010 holsters
VENDOR Steven R. Jenkins,Co., Inc SHIP City of Carml Police Department
6680 East 21st Street TO 3 Civic Square
Indianapolis, IN 46219 'Carmel, IN 46032
ATTN: Jeremy Lesh ATTN: Lt. Dwight Frost
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
10 K391 -W -G17 Gould and Goodrich holsters 100.00 1,000.00
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Send Invoice To: City of Cannel Po1i�e
ATTN: Teresa Anderson
3 Civic Square
Carmel, IN 46032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PR OJECT J PROJECTACGOUNT AMOUNT
1110 560 -02 unfform access
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�jH4T THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROP f'>� N SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. A.P.V. 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. 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 it
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
Steven R. Jenkins Co., Inc. ALLOWED 20
IN SUM OF
66$0 East 21st Street
Indianapolis, IN 46219
$1,000.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO, ACCT #ITITLE AMOUNT Board Members
I
I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
Prior Year Encumbered materials or services itemized thereon for
27117 165124 I 43- 560.02 I $1,000.00 Which charge is made were ordered and
received except
Thursday, August 11, 2011
Chief of Police
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))
12/31/10 165124 payment for holsters $1,000.00
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