174283 07/08/2009 a CITY OF CARMEL, INDIANA VENDOR: 361367 Page 1 of 1
ONE CIVIC SQUARE CORNETT ROOFING SYSTEMS CHECK AMOUNT: $2,275.00
CARMEL, INDIANA 46032 471 S RITTER AVE
4 oe La INDIANAPOLIS IN 46229 CHECK NUMBER: 174283
CHECK DATE: 7/8/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
X110 4350100 20996 7802 2,275.00 RANGE REPAIRS
r�
tornett
k2oofi +z.g Systerxls
Invoke
Metal State Copper 'Pita
471 S. Ritter Ave.
Indianapolis, IN 46219
Phone: 317- 356 -1237 Fax: 317- 357 -4382
Date Invoice
6/22/2009 7802
Bill To:
Carmel Police Department
3 Civic Sq.
Carmel, IN 46032
T
Terms Due Date
Due Upon Receipt 6/22/2009
Description Qty Rate Serviced Amount
Total Amount Due For Repairs Made Purchase Order #20996: 1 2,275.00 2,275.00
Your business is greatly appreciated
Total $2,275.00
The prices set forth above reflect a 3% discount from Cornett Roofing's standard
pricing for the applicable products and services and apply only to payments made Payments /Credits $0.00
via check which is Cornett Roofings preferred form of payment. Payments for
products and services made using credit cards are based upon Cornett Roofing's
standard prices (determined by dividing the prices set forth above by .97) and are Balance Due $2,275.00
not entitled to the discount. No surcharge is imposed by Cornett Roofing for
payments made using credit cards.
INDIANA RETAIL TAX EXEMPT PAGE 1 Of 1
C i t y of Carmel f CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
3 FEDERAL EXCISE TAX EXEMPT 20996
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
05/22/2009 Building repairs to Range
Cornett Roofing Systems SHIP City of Carmel Police Department
VENDOR 471 S. Ritter Ave. 3 Civic Square
Indianapolis, IN 46219 T Carmel, IN 46032
ATTN: Assistant Chief Tim Green
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
1 Remove nails andseams of building, lap properly
and re -screw seam sealing w /silicone 1,800.00
1 Install counter9flashing on porch 475.00
CONFIRMING Purchase Order
z -4
xz'a
Send Invoice To:�
PLEASE INVOICE IN DUPLICATE $2,275.00
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 501 Building Repairs Maint�nance
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
t VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS i I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
V THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY 10
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO A -.P�• COPY SIGN AND RETURN TO CLERK'S OFFICE
V011CHER 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
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
Cornett Roofing Systems Purchase Order No. 20996F
471 S..Ritter Avenue Terms
Indianapolis, IN 46219 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6/22/09 7802% payment for repairs to range roof 2,275.00
Total
I 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
C ornett Roofing Systems IN SUM OF
471 S. Ritter Avenue
Indianapolis, IN 46219
2,275.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
20996F 7802 501 2 275.00 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
June 29 20()q
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund