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