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Home My WebLink About180773 12/30/2009 CITY OF CARMEL, INDIANA VENDOR: 00352490 Page 1 of 1 ONE CIVIC SQUARE CHIEF SUPPLY CORP CARMEL, INDIANA 46032 Po BOX 534766 CHECK AMOUNT: $214.89 ATLANTA GA 30353 -4755 CHECK NUMBER: 180773 CHECK DATE: 12/30/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4239099 21277 309077 214.89 DRUG TEST KITS o p Please Remit: P.O. Box 534765 G Atlanta, GA 30353 -4765 MORE RESPONSIVE, PERIOD. P 800.733.9281 [1106] F 704.548.0399 www.chiefsupply.com INVOICE NUMBER INVOICE DATE 309077 12/11/09 SOLD TO: 281348 SHIP TO: 0 CARMEL PD CARMEL PD 3 CIVIC SQ INSPECTOR JOHN ELLIOT CARMEL IN 46032 -2584 3 CIVIC SQ CARMEL IN 460322584 CUSTOMER OUR ORDER ACCOUNT ORDER DATE P.O. NUMBER TERMS SHIP VIA WHSE 281348 528040 12/09/09 JOHN ELLIOT NET 30 DAYS 50 SPECIAL INSTRUCTIONS: ORDER PLACED BY: N/A SALES: C4876 INVOICE IS DUE 30 DAYS FROM INVOICE DATE. NO SHIPMENTS WILL BE MADE TO ACCOUNTS WITH PAST DUE BALANCES. ITEM NUMBER DESCRIPTION UNIT ORDER SHIP B/O PRICE EXTENSION 800 -6075 DRUG TEST E— MARIJUA EA 10 10 19.990 199.90 NEW REMITTANCE ADDRESS: CHIEF SUPPLY P O BOX 534765 ATLANTA GA 30353 -4765 These commodities, technologies, or software were (will be) exported from the U.S. in accordance with export administration regulations. Diversions contrary to U.S. law prohibited. THIS AMOUNT SUBTOTAL SALES TAX SHIPPING HANDLING TOTAL 199.90 0.00 14.99 214.89 ************DETACH THIS PORTION AND RETURN WITH REMITTANCE**************** ACCOUNT NUMBER 281348 INVOICE 309077 CUSTOMER NAME: CARMEL PD AMOUNT DUE: 214.89 W New Remittance Address: CHIEF PO Box 534765 Atlanta, GA 30353-4765 Voice 800.733.9281 Fax 704.548.0399 Ci INDIANA RETAIL TAX EXEMPT PAGE ty o ,fl e4� i+ Carml CERTIFICATE NO.003120155 002 0 of PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 21277 35- 60000972 3MME CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, AIP CARMEL INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. FOR ►`APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 PURCHASE ORDER DATE I DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION December 8 2009 drug test kit VENDOR Chief Corporation SHIP C it y of Carmel- Police Department P.O. Box 481912 TO 3 Civic Square Chard ateo, NC 28269 Carmel, IN 46032 ATM Ben Layton ATTN: 'John Ellioett CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION 10 800 -6075 Drug Test E- Marijuana 19.99 199.90 I t IY a U. 7 e City of Carmel Po r Send invoice To: ATTN: Teresa Anders 3 Civic Square Carmel, IN 46032 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 1110 390 -94 other miscellaneous PAYMENT A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE RO, NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND r VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS 1# I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. SHIP REPAID. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY 6s�•� l_t,f�. fr L��7'�lF f PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. t THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. �7 CLERK- TREASURER DOCUMENT CONTROL NO. COPY SIGN AND RETURN TO CLERK'S OFFICE VCQUCHER 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 Cast 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 Chief Supply Purchase Order No. 21277F P.O. Box 534765 Terms Atlanta, GA 30353 -4765 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 12111/09 309077 paymetn for lab supplies 214.89 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. S ALLOWED 20 Chief Suppl IN SUM OF P.O. Box 53476 Atlanta, GA 3 0353 7 214.89 ON ACCOUNT OF APPROPRIATION FOR p olice general fund Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 21277F 309077 390 -99 214.89 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 December 17 20 09 kaA,,� b Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund