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Home My WebLink About203094 10/25/2011 CITY OF CARMEL, INDIANA VENDOR: 363441 Page 1 of 1 I ONE CIVIC SQUARE NATIONAL CHILD SAFETY COUNCIL CHECK AMOUNT: $650.00 CARMEL, INDIANA 46032 PO 13OX 1368 a, JACKSON MI 49204 CHECK NUMBER: 203094 CHECK DATE: 10/25/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4345002 27747 IN 29 —C -2 650.00 PRINTING 10/11/2011 03:09 15175923962 CRAINER PAGE 02 National Child Safety Council 4 October 12, 207 t �o 12i747�w3f21h,i NCSC REPRESENTATIVE: JIM SPEEGLE w ...T,___,_._,._._._.. NCSC PROGRAM NO. -C -2 ...__...:,w ATTENTION, Teresa Anderson SHIP TO: Carmel Police Department NCSC COPY STREET 3 Civic Square CITY Carmel STATE i ZI P 46032 NCSC Materials Requested REQUESTEU E',Y Teresa Anderson Cost Each Total r... ..�.....,..�.....v,,. W.,_, wd.,...,....._ ..._....,�w....,.,.........�... Cost NCSC ITEM REQUESTED NCSC ITEM o Quantit�r SS Home Security 5704 200 0 25 $50.00 d 00 SS Personal Safety 5710 200 25 $50,.Q0 0 200 57p9 SS Cons Scams 3U0 $9 25 0 0Q 1 Good Gu s /Bad Guys Police Or4c�inal Badges 77 1 000 0 1 5._ $1 00 154 200 0.32 $6 Bike Mini Book Halloween 7ri -Fold 340 20 $60 00 151 Bike Basie Quiz 300 0 20 $60 O0 155 Bike Safety et Book Marks 300 015 $45 00 635 Personal Safy 'T" r 4 fold 100 0 25 $25 OO j -..W 'Tt ;talW 31 0 .....$654.00. Reason Re neste For Use By Police Department SHIP ASAP ...THANK YOU!!n INDIANA RETAIL TAX EXEMPT PAGE City O C aanal CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 2447 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 r _T MIMI NOlona1 Child W* Council Camel Police Dopar moat VENDOR SHIP 3 CIVIC squm P.O. Bast im TO Came IN Ja1choon, 01 4M4M (3 ®I) 5 Y M CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT A ccount OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 43 4 g{ .02 200 Each Nome Security pamphlets 5704 $0.25 $50.00 300 Each How to Tell the good Cuya from the Sad 111 $0.32 $90.00 GW 2 Each Polica 1`lonoraryMember badge stickers 7 $73.00 $150.00 200 Each Persil SaV®ty� 71:0 f $0.25 $50.00 200 Each Pedal Paw with Sa up p Mph�� s ��o l'� $0.32 $04.00 300 Each peep Your Little Monsters Sa�i 074 $0.20 800.00 oo 300 Each Sa felypup's Bicoe Sad basic 151 11 $0.20 $60.00- pamphlets f 1 200 Each cods Scams pamph 5, 'S�o9 a $0.25 $50.00 300 Each Rine Safety Bookmarks a �5 1. $0.15 $45.00 1 00 Each Are You Protecting You' "i pamphlet -P0 3; $0.25 $25.00 Sum Total: $050.00 O GPI Send Invoice To: Camel Police DopEirtmGnt Attu: Tomsal Andoraow 3 CIVIC 6qum Carmel, IN 4 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dept. 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 CERTIF HAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPR �UFFICIENTiT0 PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. l PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. �al� v THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chi if oq Polies AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK TREASURER DOCUMENT CONTROL NO-27747 A.P.V. CONY 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 VOUCHER NO. WARRANT NO. ALLOWED 20 National Child Safety Council IN SUM OF 227 North Harris Avenue Columbus, OH 43204 $650.00 ON ACCOUNT OF APPROPR[ATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 27747 I IN 29 -C -2 I 43- 450.02 I $650.00 1 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 Thursday, October 20, 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)) 10/12/11 IN 29 -C -2 national night out supplies $650.00 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 411 i OP I;) National Q 1.1. Safety Counci( er A Nonprofit Charitable Federal Tax exempt Organization Dedicated to the Safety Tax-exempt Children National Office: 4065 Page Ave. P.O. Box 1368 Jackson, Michigan 49204 -1368 (517) 764 -6070 CO 1s ACKNOWLEDGEMENT OF CHARITABLE CONTRIBUTION As a representative of the following named tax exempt organization, I hereby acknowledge receipt of the below cited charitable contribution by City of Carmel, Indiana I certify that these funds represent a gift to our organization with no return benefit in the form of goods or services derived by the donor corporation. If there is a derived benefit to the corporation, I have attached a statement specifying that benefit and its value. National Child Safety Council is a tax- exempt 501(c)(3) organization, FEIN: 38- 6035290. Name of Recipient Organization: National Child Safety Council Dollar Amount Received: 650.00 Check No. 203094 Receipt No. A281061 Address: 4065 Page Avenue PO Box 1368 Jackson, MI 49204 -1368 Signature of Certifying Individual: C 7 c zy 4l-L ?T Alvin E. Elliott, President Date: November 30, 2011 Attached Statement Yes No X "Next to creating a life, the greatest thing one can do is save a life." A. Lincoln