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Home My WebLink About170342 04/01/2009 CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1 0 ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $1,381.80 CARMEL, INDIANA 46032 7001 WOOSTER PIKE MEDINAOH 44256 CHECK NUMBER: 170342 CHECK DATE: 4/1/2009 D EPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 900 4359005 20077 120511 1,381.80 CAR SEATS child source Invoice Invoice Number: 0000120511 7001 Wooster Pike, Medina, OH 44256 Ph: 330.723.4739 Fax: 330.721.6799 Invoice Date: 3/11/2009 REMITTANCE ADDRESS: Invoice Due Date: 4/10/2009 WESTERN RESERVE DISTRIBUTING, INC. dba CHILD SOURCE Customer: CARMPD P.O. BOX 73714 Sales Order: 0000083349 CLEVELAND, OH 44193 Tax ID 482- 0563593 S 'Id TO S1iip To pe ate a CARMEL POLICE DEPARTMENT, CITY OUR LADY OF MT CARMEL 3 CIVIC SQUARE 1045 W 146TH STREET CARMEL, IN 46032 -2584 USA ATTN MAGGIE 317- 81.9 -0772 Carmel, IN 46032 USA Customer P.O:: Ship ':V�a al F.O B„ f Terms a ��n 20077 FEDEX GRND ORIGIN Net 30 Days i t10 se Dert P I1, a a n -ter17] Uf11tPr1Ce rem Amount Q hPP 93- 12OFSM SCEN'ERA 4 HNS POS (2/PK) 14 43.000 602.00 93- 209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 6 47.200 283.20 93- 299FSM BACKLESS SHIELDLESS BOOSTER (4 PER PACK) 4 14.900 59.60 3321198 EVENFLO EMBRACE INFANT SEAT 4 65.800 263.20 LAST ITEM i i I i Tracking Numbers: 06644371 1 451 987, 066443711451994, 066443711452007, 066443711452014, 066443711452021, 066443711452038, 066443711452045, 066443711452052,066443711452069 ,066443711452076, 066443711452083, 066443711452090, 066443711452106, 066443711452113,066443711452120 MULTI WEIGHT Subtotal 1,208.00 Freight 173.80 Sales Tax 0.00 Payment/Credit Amount 0.00 7,°�Balance 1 INDIANA RETAIL TAX EXEMPT PAGE C o II C rme CERTIFICATE NO.003124155 402 0 1 of 1 q1' 11 CuL `L JL PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 20077 310f� CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, AI P CARMEL INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPdNDENCE. FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CAR MEL 1997 PURCHASE ORDER DATE I DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION March 10, 2009 car seats VENDOR Child Source SHIP Our Lady of Mt. Carmel 7001 Wooster Pike TO 1045 W. 146th Street Medina, OH 44256 Carmel, IN 46032 ATTN: Maggie 317 -819 -0772 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION 14 93- 120FSM Seenera 4 tins Pos car seats 43.00 602.00 6 93- 209FSM High back booster front Adj car seats 47.20 283.20 4 93- 299FSM Backless Shieldless booster car seats 14.90 59.60 4 3321198 Evenflo Embrace infant car seats 65.80 263.2q shipping 173.80 v l City f Carmel Po Send Invoice To: Y C''m ATTN: Teresa Anderso 3 Civic Xquare w_ Carmel, IN 46032 PLEASE INVOICE IN DUPLICATE 1,381 DEPARTMENT ACCOUNT T PROJECT PROJECTACCOUNT AMOUNT 900 590 -05 car seats 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 f VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS T I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATIONS rFF�TOPAY THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. j THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE ASsiyant Chief of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO 2 0 CLERK- TREASURER DOCUMENT CONTROL NO. A.P. COPY- SIGN AND RETURN T CLERK OFFICE VOt)CHER NO._— WARRANT NO.__ ALLOWED 20 T 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 Child Source Purchase Order No. 20077F 7001 Wooster Pike Terms Medina, OH 44255 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 11 a ent for car seats 1,381.80 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 hild Source IN SUM OF 7001 Wooster Pike Medina, OH 44256 1,381.80 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 20077P 120511 590 -05 1,381.80 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 March 25 20 09 *,�4� b, Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund