205434 01/17/2012 *f CITY OF CARMEL, INDIANA VENDOR: 353565 Page 1 of 1
ONE CIVIC SQUARE CROWN TROPHY
CARMEL, INDIANA 46032 807 W CARMEL DRIVE CHECK AMOUNT: $766.50
CARMEL IN 46032
.o. o CHECK NUMBER: 205434
CHECK DATE: 1/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 R4230000 25923 14640 766.50 PARKING PERMITS
CROWN TROPHY
Invoice
Date Invoice
807 West Carmel Drive 12/29/2011 14640
Carmel, Indiana 46032
Bill To
City of Carmel
1 Civic Square
Carmel, IN 46032
P.O. No. Terms Due Date
o j sod; 3 Net 30 1/28/2012
Item Qty Description Rate Amount
PNTAGS 250 585 Window Hanger with one color imprint on 1.70 425.00T
one side
Misc 250 2nd Color Imprint 0.65 162.50T
Misc 250 Back Side Imprint 0.65 162.50T
Shipping 1 Shipping Handling Charge 16.50 16.50
Sales Tax (0.0 $0.00
Thank You For Selecting Crown Trophy For Your Total $766.50
Awards Recognition Needs, Payments /Credits $0.00
Balance Due $766.50
Phone Fax E -mail Web Site
317 818 -9400 317 818 -9200 crowncarmel @sbcglobal.net www.crowntrophy.com
0 INDIANA RETAIL TAX EXEMPT PAGE
rme 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 :1NDIANA 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
IMAM
Drom Trophy Cumol Pollco Dopatmont
VENDOR SHIP 3 Civic Squm
M7 West Carpel Ddvo TO Carm IN 4MM
Dannol, IN 4 32 (317) 579
C B LANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42.00
1 Each wind@a hanger parldng perrnhs $776.50 $776.50
Sub Total: $776.50
r
Q0 6r
end Invoice To: v
Damol Pollea Dopattmonit
Attn: Yemsa Andorson
3 Civic squm
D@aol, IN 411 2= PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
tel Police Dept, PAYMENT X776.50
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 AyTHERE IS AN UNOBLIGATED BALANCE IN
!IP REPAID.
THIS APPROPRI O SUFFICIENT TO PAY FOR THE ABOVE ORDER.
).D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
RCHASE ORDER NUMBER MUST APPEAR ON ALL
i1PPING LABELS. log QQ P o Nco
IS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
1@�C,ZS���NDFZ�F`t��EAFOF aNOSUPP�EMENZZHFAF�o.
CLERK TREASURER
A P V. COPY SIGN AND RETURN TO CLERK'S OFFICE
1CUMENT CONTR0 W
VOUCHER NO. WARRANT
ALLOWED 20
IN THE SUM OF
S
ON ACCOUNT OF APPROPRIATION FOR F
a
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))
12/29/11 14640 parking permits $766.50
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. WA RRANT NO.
ALLOWED 20
Crown Trophy
IN SUM OF
807 West Carmel Drive
Carmel, IN 46032
$766.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Prior Year Encumbered I hereby certify that the attached invoice(s), or
25923 I 14640 I 42- 300.00 I $766.50
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, January 12, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund