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HomeMy WebLinkAbout204192 12/06/2011 CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1 ONE CIVIC SQUARE CHILD SOURCE CARMEL, INDIANA 46032 7001 WOOSTER PIKE CHECK AMOUNT: $569.10 MEDINA OH 44256 CHECK NUMBER: 204192 CHECK DATE: 12/6/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 900 4359005 25888 180134 569.10 CAR SEATS child source Invoice WHOOMMMORM Invoice Number: 0000180134 7001 Wooster Pike, Medina, OH 44256 Ph: 330.723.4739 Fax: 330.721.6799 Invoice Date: 11/9/2011 REMITTANCE ADDRESS: Invoice Due Date: 12/9/2011 WESTERN RESERVE DISTRIBUTING, INC. dba CHILD SOURCE Customer: CARMPD P.O. BOX 73714 Sales Order: 0000104044 CLEVELAND, 01 -1 44193 Tax ID 482- 0563593 Sold To Ship CARMEL POLICE DEPARTMENT, CITY CARMEL POLICE DEPARTMENT 3 CIVIC SQUARE 3 CIVIC SQUARE CARMEL, IN 46032 -2584 USA ATTN A GALLAGHER Carmel, IN 46032 USA ,;:;_.customer [?:0. s :Sh►, V►a. �F:O:B =Tehrs 25888 FEDEX GRND ORIGIN Net 30 Days :dtein Descri °Q Shipp Ui it Price' Amount ICO34AOB SAFETY Ist DESIGNER CARSEAT 5 -22# W /BASE 2 63.9000 127.80 (NORDICA) 93- 12OFSM SCENERA 4 HNS POS (2 /PK) 6 43.0000 258.00 93- 209FSM HIGH BACK BOOSTER FRONT AD.I 2PK 2 47.2000 94.40 LAST ITEM Tracking Numbers: 066443715345398, 066443715345404, 066443715345411, 066443715345428, 066443715345435, 06644; Subtotal 480.20 Freight 88.90 Sales Tax 0.00 Payment /Credit Amount 0.00 Balance 569.10 INDIANA RETAIL TAX EXEMPT PAGE City Carmel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 2„$, 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. PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION i i MAI I Child Sourco Coo! Pollen Dopwtmont VENDOR SHIP 3 CIVI sgUam 7001 Wbos4or Pik' TO C ml, IN 4M Modii Off! 44256 (w) 671 M CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT I QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Aeeount 00 .E 9 Each shipping charges $88.00 $88.00 2 Each High Back Booster Front Mj 03- 209FSM $47.20 $04.40 6 Each Scenery 4 HN POS 9 F $43.00 $258.00 2 Each Safety 9sf Designer Car Seas 4' $63.90 $927.80 Saab `dotal: $569 a >end Invoice To: 0 Carmel P ollce Depautmonf Attn: Tmsal Andmrson 3 CIVIC Squat l Ca>m'Iml, IN mm. PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT I PROJECTACCOUNT AMOUNT m ei Police Dept. C-" PAYMENT 0M.10 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 HAT HERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROP FFICIENT TO PAY FOR THE ABOVE ORDER. .O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY 'URCHASE ORDER NUMBER MUST APPEAR ON ALL IHIPMNG LABELS. HIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE g hlof oq pollco 1 4D ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 8 88 CLERK TREASURER ICUMENT CONTROL N0. A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE NM VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR Board Members f PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or r bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and my, x received except F 4 x L r 20 Signature Title Cost distribution ledger classification if R claim paid motor vehicle highway fund aa. 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)) 11/09/11 180134 car seats $569.10 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 VOUC NO. WARRANT NO. ALLOWED 20 Child Source IN SUM OF 7001 Wooster Pike Medina, OH 44256 $569.10 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Grant Fund PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 25888 I 180134 I 590.05 I $569.10 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, December 01, 2011 Z Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund