HomeMy WebLinkAbout202952 10/25/2011 CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1
�fl ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $994.20
CARMEL, INDIANA 46032 7001 WOOSTER PIKE
MEDINA OH 44256 CHECK NUMBER: 202952
CHECK DATE: 10/25/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
900 4359005 27942 179007 994.20 CAR SEATS
child so rce Invoice
Invoice Number: 0000179007
7001 Wooster Pike, Medina, 01 -1 44256
Ph: 330.723.4739 Fax: 330.721.6799 Invoice Date: 10/13/2011
REMITTANCE ADDRESS: Invoice Due Date: 1 1/12/201 1
WESTERN RESERVE DISTRIBUTING, INC.
dba CHILD SOURCE Customer: CARMPD
P.O. BOX 73714 Sales Order: 0000103458
CLEVELAND, 01-1 44193
Tax ID 482- 0563593
._Sol To Ship To
CARMEL POLICE DEPARTMENT, CITY CARMEL POLICE DEPARTMENT
3 CIVIC SQUARE 3 CIVIC SQUARE
CARMEL, IN 46032 -2584 USA ATTN A GALLAGHER
Carmel, IN 46032 USA
Customer -P .O. Slip Via F,.rJ: _Terms
27941 FEDEX GRND ORIGIN Net 30 Days
Item Descri Qty Shipp Unit Price Amount
ICO34AOB SAFETY Ist DESIGNER CARSEAT 5 -22# W /BASE 5 63.9000 319.50
(NORDICA)
93- 1201:'SM SCENERA 4 HNS POS (2 /PK) 6 43.0000 258.00
93- 209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 6 47.2000 283.2 0
LAST ITLM
I
Tracking Numbers: 066443715323341, 066443715323358, 066443715323365, 066443715323372, 066443715323389, 06644:
Subtotal 860.70
Freight 133.50
Sales Tax 0.00
Payment /Credit Amount 0.00
Balance 994.20
INDIANA RETAIL TAX EXEMPT PAGE
C of C armel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 27941
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
101911A9 9
Child Gourco Camol Police Dop @dmont
VENDOR SHIP 3 CIVIC squam
7001 W000tor Plhc TO ftn1 o l, IN 0M
Medina, 014 44 (317) 571
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS J FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 00.15
9 Each shipping charges $133.50 t 33.50
6 Each High Back Booster Front Adj 93- 209FSM $47.20 $283.20
6 Each Sconera 4 HN POS 93 1i $43.00 $258.00
5 Each Safety Ist Designer Car Seat CO i? $63.90 $399.50
c o Slab Total: $994.20
l 4�
V �e a p t Y
TfinhCllnle
Send Invoice o:
�1
Cannel Polico DePaftn98nt
Attn: Terosa Andorson
3 Civic Squm
Cannel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept° C� PAYMENT .20
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 TTHERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROP IATION,UFFI LENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. Aof of ®ll�.�c
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 .a TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL No A.P.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 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))
10/13/11 179007 car seats $994.20
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
Child Source
IN SUM OF
7001 Wooster Pike
Medina, OH 44256
$994.20
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Grant Fund
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
2794A' 179007 590.05 $994.20 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
Friday, October 21, 2011
A
�a
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund