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Home My WebLink About168414 02/04/2009 CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1 ONE CIVIC SQUARE CHILD SOURCE y� CARMEL, INDIANA 46032 7001 WOOSTER PIKE CHECK AMOUNT: $3,190.47 MEDINAOH 44256 CHECK NUMBER: 168414 CHECK DATE: 2/4/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMB AMOUNT DESCRIPTION 900 4359005 19019 115798 1,508.71 CAR SEATS 900 4359005 19020 115828 1,681.76 CAR SEATS r i source Invoice 9% 'Q� Invoice Number: 0000115798 7001 Wooster Pike, Medina, OH 44256 fir Ph: 330.723.4739 Fax: 330.721.6799 Invoice Date: 1/12/2009 REMITTANCE ADDRESS: 0 �ig Invoice Due Date: 2/11/2009 WESTERN RESERVE DISTRIBUTING, INC. dba CHILD SOURCE Customer: CARMPD P.O. BOX 73714 Sales Order: 0000081841 CLEVELAND, OH 44193 Tax ID #82- 0563593 �pld Toja' as ZI ..e,.: w� e 38w CARMEL POLICE DEPARTMENT, CITY CARMEL POLICE DEPT 3 CIVIC SQUARE 3 CIVIC SQUARE CARMEL, IN 46032 -2584 USA ANN GALLAGHER 317 571 -2720 Carmel, IN 46032 USA Customer P O l Sfii Via F.:p B Terms _..P s a i 19019 LTL ESTES ORIGIN Net 30 Days i Ifem Des c,i,� p tion,x_ Q UniC'Price .ilirioint 22- 322LGA SAFETY 1st DESIGNER CARSEAT 5 -224 WBASE 7 S 63.900 S 447.30 93- 12OFSM SCENERA 4 HNS POS (2/PK) 6 43.000 258.00 22- 12OFSM SCENA.RA 1 PK CARSEAT 6 44.000 264.00 93- 209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 6 47.200: 283.20 93- 299FSM BACKLESS SHIELDLESS BOOSTER (4 PER PACK) 8 14.900 f S 119.20 k LAST ITEM i s i j Tracking Numbers: 155 1004733 Subtotal 1,371.70 Freight 137.01 Sales Tax 0.00 Payment/Credit Amount 0.00 'eBa' lance 1508.71 sou'� Invoice Invoice Number: 0000115828 7001 Wooster Pike, Medina, OH 44256 t� Ph: 330.723.4739 Fax: 330.721.6799 Invoice Date: 1/13/2009 REMITTANCE ADDRESS: C� Invoice Due Date: 2/12/2009 WESTERN RESERVE DISTRIBUTING, INC. dba CHILD SOURCE Customer: CARMPD P.O. BOX 73714 Sales Order: 0000081842 CLEVELAND, OH 44193 Tax ID 482- 0563593 CARMEL POLICE DEPARTMENT, CITY OUR LADY OF MT CARMEL 3 CIVIC SQUARE 14598 OAK RIDGE RD CARMEL, IN 46032 -2584 USA ATTN: MAGGIE Carmel, IN 46032 USA C ustomer P 0 r.4 Ship Via 19020 FEDEX GRND ORIGIN Net 30 Days "'item, q.Descri ton tv'Slii ed t Amo u`n't P Uni Price F 93- 209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 16 47.200: 755.20 22- 322LGA SAFETY 1st DESIGNER CAR.SEAT 5 -229 W /BASE 10 63.900 i 639.00 93- 299FSM BACKLESS SHIE'LDLESS BOOSTER (4 PER PACK) 4 14.900 59.60 LAST ITEM -E I i, i I II I I E Tracking Numbers: 066443711373517, 066443711373524, 066443711373531, 0664437.11373548, 066443711373555, 066443711373562, 066443711373579, 066443711373586, 066443711373593 ,066443711373609, 066443711373616, 066443711373623 ,066443711373630, 066443711373647,066443711373654 Subtotal 1,453.80 Freight 227.96 Sales Tax 0.00 Payment/Credit Amount 0.00 t F Balaiiae 1,681.76 INDIANA RETAIL TAX EXEMPT PAGE Ci of C armel CERTIFICATE NO. 003120155 002 0 JJLL PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 14 3 OUE;CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, "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 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION January 8, 200£ car seats VENDOR Child Source SH IP City of Carmel Police Department 7001 Wooster Pike TO 3 Civic Square Medina, OH 44256 Carmel, IN 46032 ATTN: Ann Gallagher 317 -571 -2720 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT OUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION 7 22- 322LGA Safety 1st Designer Carseat w /base 63.90 447.30 6 93- 12OFSM Scenera 4 Harness 43.00 258.00 6 22- 12OFSM Sce PK carseat 44.00 262.00 6 93- 209FSM High Back Booster Front ad3 47.20 283.20 8 93- 299FSM Backless Shieldless BOoster 14.90 119.20 freight 137.01 `fit �g `tip a Catty of Carmel Po ik Send Invoice To: ATTN: Teresa Anders 3 Civic 0quare Carl, IN 4 PLEASE INVOICE IN DUPLICATE 1,508.71 rr DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 900 590 -05 car seat grant PAYMENT f 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 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. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO, DOCUMENT CONTROL NO. UAJ COPY SIGN AND RETURN TO CLERIC'S OFFICE VOUCHER NO. WARRANT NO._._ ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR Board Members PO P' INVOICE N0. ACCT /7"ITI_E 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 s 20 Signature Title �I Cost distribution ledger classification if i claim paid motor vehicle highway fund INDIANA RETAIL TAX EXEMPT PAGE C i t y of .0 rmel CERTIFICATE NO.003120155 002 0 �J' 1i ILJ�L U✓ 1� PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 0 3 &CIVIC SQUARE rSHtPP11NG IS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA 46032 -2584 UCHER, DELIVERY MEMO, PACKING SLIPS, LABELS AND ANY CORRESPONDENCE. FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION Januar 8 200 car seats VENDOR Child Source SHIP Our Lade of Mt. Carmel Trinity Clinic 7001 Wooster Pike TO 14598 Oak Ridge.Road Medina, OH 44256 Carm&J, IN 46032 ATTN: Maggie CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION 16 93-- 209FSM high Back. Booster Front adP, 47.20 755.20 10 22-322LGA Safety 1st'Designer carseat w /base 63.90 639.00 4 93- 299FSM Backless Shieldless Booster 14.90 59.60 freight 227.96 m tl 'mss+••" ~C•e� m Send Invoice To: City of Carmel Pol ATTN: Teresa Anderson 3 Civic Square Carmel, IN 46032 PLEASE INVOICE IN DUPLICATE 1,681.76 DEPARTMENT ACCOUNT I PROJECT PRO_JECTACCOUNT AMOUNT 900 590 -05 car seat grant PAYMENT 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 THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. SHIP REPAID. f C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY I LlV9 lIL"t/9/I A SHIPPING LABELS. f 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 V61-ICHER NO._— WARRANT NO._.___ ALLOWED 20 n IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR t Board Members PO# or INVOICE NO. ACCT #ITITLE 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 I 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 Child Source Purchase Order No. 1902OF 19019F 7001 Wooster Pike Terms Medina, OH 44256 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 1/13/09 115828 payment for car seats 1,681.76 1/12/09 115798 paymetn for car seats 1,508.71 Total 3,190.47 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 VOU%HER NO. WARRANT NO. ALLOWED 20 Child Source IN SUM OF r. 7001 Wooster Pike Medina, OH 44256 3,190-47 ON ACCOUNT OF APPROPRIATION FOR police grant fund Board Members PO# or INVOICE NO. ACCT /TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 19019F IIS798 5go-os 1,9()8, 1 bill(s) is (are) true and correct and that the 1902OF 115828 590 --05 1,681.76 materials or services itemized thereon for which charge is made were ordered and received except January 19 20 09 Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund