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Home My WebLink About204057 11/21/2011 CITY OF CARMEL, INDIANA VENDOR: 364949 Page 1 of 1 ONE CIVIC SQUARE WORKPLACE SOLUTIONS CARMEL, INDIANA 46032 919 N COLISEUM BLVD CHECK AMOUNT: $823.50 FT WAYNE IN 46805 CHECK NUMBER: 204057 CHECK DATE: 11/2112011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 R4463000 27218 43639 823.50 CHAIRS Tl�r TNVbICE: 93639 VV Fort Wayne Warsaw DATE 10/31/11 Ph: 260 -422 -8529 Fax: 260 422 -6815 919 Coliseum Blvd. North 46805 PROO 6 111 www.workspacesolutions.com PROPOSAL: 14 601 i B T'T, T. TO: INSTALL AT: CLIENT NUMBER.: 006154 CITY OF CARMEL CITY OF CARMEL ONE CIVIC SQUARE ONE CIVIC SQUARE CARMEL', IN 46032 CARMEL, IN 46032 CUSTOMER P /O: TERMS SALESPERSON 27944 NET 15 Gary MCDermid F TY' PRODUCT DESCRIPTION SE.L� EXTENDED 3 MFT9450 MESH BACK. TASK CHAIR W/ UPH 247.00 741.00 SEAT W/0 SEAT SLIDE FEATURES- TILT' ENSION" CONTROL CENTER T1'1T I TILT L'OCK::." BACK ANGLE' ADJ SEAT HEIGHT ADJ WATERFALL SEAT 4 FORWARD SEAT TILT SEAT DEPTH ADJ ADJ ARMS SEAT ANGLE ADJ RLACK 5806 1 l 1 LABOR LABOR delivery only. 82.50 82.50 INSTALLATION TO OCCUR DURING NORMAL BUSINESS HOURS OF 8:00 I A.M. 4:00 P. MONDAY L RT•DAY-, I I SUBTOTAL 191.00 INSTALL.....: 82.50 FINAL TOTAL. :4 823 50 PAY T HIS AMOUNT......:i 823.50 PAGE OF 1 j INDIANA RETAIL TAX EXEMPT PAGE City Y f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORD R NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 9 3RMEE1CIVIC 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. DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION D ecember 21 2)10 airs VENDOR Workspace Solutions SHIP City of Carmel Police Department 919 Coliseum Botl1b6i3hrd TO 3 Civic Square Fort Wayne, IN 46805 Carmel, IN 46032 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION 2 chairs 300.00 600.00 ,w 2 11 cl iIJ Send Invoice To: s jam EI PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 1110 630 furnl1mre and fixtures 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 AFPIDAVITATTACHED. I HEREBY CERTIFY THATTHERE IS AN UNOBLIGATED BALANCE IN SHIPPING INSTRUCTIONS THIS APPROPAIATION•SIJF I LENT TO PAY FOR THE ABOVE ORDER. SHIP REPAID. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Assistant Chief of Police AND ACTS AMENDATORY THEREOP AND SUPPLEMENT THERETO. CLERK- TREASURER DOCUMENT CONTROL NO. 2 7 2 1 8 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 #1TITLE 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 Workspace Solutions IN SUM OF 919 Coliseum Boulevard Fort Wayne, IN 46805 $823.50 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1110 43639 44- 630.00 $223.50 I hereby certify that the attached invoice(s), or Encrunbered bill(s) is (are) true and correct and that the 27218 43639 44- 630.00 $600.00 materials or services itemized thereon for which charge is made were ordered and received except Monday, November 21, 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)) 10/31/11 43639 chairs $223.50 10/31/11 43639 chairs $600.00 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