166378 11/24/2008 CITY OF CARMEL, INDIANA VENDOR: 00351087 Page 1 of 1
ONE CIVIC SQUARE SEARS COMMERCIAL ONE
CARMEL, INDIANA 46032 PO BOX 689134 CHECK AMOUNT: $116.99
DES MOINES IA 50368 -9134
CHECK NUMBER: 166378
CHECK DATE: 11/24/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4464000 18973 T718683 116.99 MICROWAVE
f Yi
Page 1 of 3
Sequence -2884
CommerdalOnW ACCOUNT NUMBER 5405 5340 0749 1101
CUSTOMER SERVICE 1 -800- 599 -9712
Account Total Available Billing Cycle Payment Minimum
Balance Credit Line Credit Closing Date Due Date Payment Due
$125.18 $3,000 $2,874 11/11/08 12/06/08 $125.18
Account Summary
Previous Balance $0.00
Payments $0.00
Returns/Exchanges/Adjustments $0.00
Purchases Debits $125.18
Account Balance $125.18
Purchasing Account 5405 5340 0749 1101
Current Purchases and Debits
Detail enclosed for new purc hase items since last statement.
Trans Post Sears Purchase
Date Date Purchase Location Invoice Customer PO Order Amount
10127 10127 SEARS 1600 INDIANAPOLIS IN T718663 ROBERT ROBINSON $125.18
20081027001600 "182R1528
Total Purchases and Debits for Account Number 5405 5340 0749 1101 $125.18
Total Account Activity for Account Number 5405 5340 0749 1101 $125.18
In Case of Errors or Questions About Your Bill Payment Information
If you think your invoice or billing statement is wrong, Payment must be mailed to us at the payment address
or if you need more information about a transaction shown on the reverse side. Payments that are received
thereon, write us on a separate sheet at the inquiry in the mail at the designated address before 9:00am (CST)
address listed on the reverse side as soon as possible. on any Monday through Friday that is not a holiday will be
We must hear from you no later than 30 days after we credited as of the day of receipt. If payment is not made
first sent you the invoice or billing statement on which as provided herein, crediting may be delayed up to 5 days.
the error or problem appeared.
You agree not to send us partial payments marked
You must contact us in writing in order to preserve your "paid in full "without recourse or similar language
rights. In your letter, give us at least the following information: unless such payments are marked for special handling
-Your name and account number and sent to the inquiry address on the reverse side.
The dollar amount of the suspected error The Sears Commercial One Account is issued by
Describe the error and explain, if you can, why Citibank (South Dakota), I.A..
you believe there is an error. If you need more
information, describe the item you are unsure about.
S-ears SEARS COMMERCIAL ONE Page 3 0/ 3 CARMEL POLICE DEPT
Commercial®nW PO BOX 630859 ATTN ACCOUNTS PAYABLE
IRVING, TX 75063 -0859 3 CIVIC SQ
CARMEL IN 46032 -2584
Information 4 Transactlan ,.I' 1
Payment Due Date: 12/06/08 Purchase Location: INDIANAPOLIS Statement Date: 11/11/08
Name: CARMEL POLICE DEPT Customer PO ROBERT ROBINSON
Invoice T718683 Invoice Amount: $125.18 Sears Order
Invoice Date: 10/27/08 Cardholder Name: CARMEL POLICE DEPT Purchase Card 5405534007491101
Ship to Address: ROBERT ROBINSON
CARMEL, IN
Quantity SKU /Description Unit Price Total Price
1 02063259000 KM MICROWAVE, 1.2/1200W $116.99 $116.99
Payment Address: SEARS COMMERCIAL ONE Total Price: $116.99
PO BOX 689131 Tax: $8.19
DES MOINES IA 50368 -9131 Delivery: $0.00
For Customer Service Call: 1- 800 599 -9712 Grand Total: $125.18
INDIANA RETAIL TAX EXEMPT PAGE C it y of Carmel CERTIFICATE NO.003120155 002 0 I f PURCHASE ORDER NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 l
3 100 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
)ctober 29, 2008 microwave
VEN19OR Sears SHIP City of Carmel. P olice Deparl!Ment
TO 3 Civic Square
Carmel, IN 46032
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1 Black Kenmore 1.2 cu. ft. countertop microwave- 116.99
A
o
Send Invoice To:
1
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT/ PROJECT ACCOUNT AMOUNT
1110 640 office equipment PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
I 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 A SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY ``��Ir
PURCHASE ORDER NUMBER MUST APPEAR ON ALL l
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. COPY SIGN AND RETURN TO CLERK'S OFFICE
)TOUCHER NO. WARRANT NO.
a
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 T
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescr.ti:d 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
Sears Commercial One Purchase Order No. 18973F
P.O. Box 689131 Terms
Des Moines, IA 50368 -9131 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11/11/08 payment for microwave 116.99
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
Sears Commercial One IN SUM OF
P.O. Box 689131
Des Moines, IA 50368 -9131
116.99
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT voice(s), or
DEPT. I hereby certify that the attached in
18973F 640 116.99 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 20 20 08
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund