205304 01/05/2012 CITY OF CARMEL, INDIANA VENDOR: 00350674 Page 1 of 1
ONE CIVIC SQUARE ULINE
CARMEL, INDIANA 46032 2200 SOUTH LAKESIDE DR CHECK AMOUNT: $441.35
WAUKEGAN IL 60085 CHECK NUMBER: 205304
CHECK DATE: 1/512012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4463000 41526273 47.35 FURNITURE FIXTURES
1110 R4463000 25917 41526273 394.00 SHELVING
INVOICE NO.
1- 500 295 -5510
uline.com 41526273
2200 S. Lakeside Drive Waukegan, IL 60085 INV OICE
SHIPPING SUPPLY SPECIALISTS ULINE FED ID 36- 3684738
THANK YOU FOR YOUR ORDER. ULINE CUSTOMER SINCE 2003
YOUR ORDER 44945478
SOLD TO: SHIP TO:
MDG2010 00026616 1 AB 0368
�11' ��II'' I"' I�' I II I I II' I' II I I I I��I llllll l l �l�l ll CARMEL CITY OF
CARMEL CITY OF POLICE DEPT
POLICE DEPT 3 CIVIC SQ
3 CIVIC SQ CARMEL IN 46032 -7570
CARMEL IN 46032 -7570
U -100 8 -2010
e e a ORDER DATE 1• o a
447339E ROBERT UPS GROUND 12/13/11 12/13/11 NET 30 DAYS 12/13/11
2 KT H -1206 48X24X72 WIRE SHELVING UNIT 197.00 394.00
�RDEP. -PL ACED S` P.^ °ERT ROB!NSON SUB =TOTAL SALES FRT /HNDLING AMOUNT'DUE
INTERNET /1 394.00 .00 47.35 441.35
INDIANA RETAIL TAX EXEMPT PAGE
C ity o
f.,Carmel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2%17
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED<BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
92iai209 i
ullne Carmol police Dopafton4
Accounts Rpcolvable SHIP 3 Civic 8qum
VENDOR
2200 Louth Lakoside Drivo TO Cumol, I N 4M
Vftukogar, IL OM 571 =2
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 44.00 00 3 /%I
2 Each shelving H -4200 $980.00
Sub Total: $378.00
a
0
Send Invoice To:
f
Carmel Police Departmont
Attn: Torossi Anderson
3 Civic squm
Carmel, IN 2- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Caramel Police Dept. �L PAYMENT 78.00
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 THAY THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRI Tr UFFICIENT T PM"FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
C G 0 P
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE b (d Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL No- 25 9 17 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF
V
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))
12/13/11 41526273 shelving $441.35
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
Uline
Accounts Receivable
IN SUM OF
2200 South Lakeside Drive
Waukegan, IL 60085
$441.35
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
r
Prior Year Encumbered I hereby certify that the attached invoice(s), or
25917 41526273 44- 630.00 $441.35
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
Tuesday, January 03, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund