205781 01/31/2012 CITY OF CARMEL, INDIANA VENDOR: 365926 Page 1 of 1
1 ONE CIVIC SQUARE ASSOCIATED INTERIORS, INC CHECK AMOUNT: $3,165.00
5.' CARMEL, INDIANA 46032 2435 KENTUCY AVE
INDIANAPOLIS IN 46221 CHECK NUMBER: 205781
CHECK DATE: 1/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 R4350100 25951 6495 3,165.00 OFFICE WALL
As SOCIATED INTERIORS, INC.
2435 Kentucky Avenue
Indianapolis, Indiana 46221
(317) 244 -5399
(317) 244- 5593/fax MMM
Sold To: I Invoice No.: 6495
Name: City of Carmel P.O. 25951
Address: One Civic Square Date: 17- Jan -12
Carmel, IN 46032 -2584 Salesman: Les
Job Name: Carmel Police, Department Shipped Via: Associated Interiors
Qty Description Price Total._
Labor and mat to install drywall partition, insulation.
Paint, base, and door unit.
Per Proposal 3165.00
Total Lump Sum Contract TOTAL $3,165.00
Payment Details: Net 15 days
INDIANA RETAIL TAX EXEMPT PAGE
City o a� �me� CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2MI
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/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
'URCHASE ORDER DATE DATE REQUIREDI REQUISITION NO. VENDOR NO. DESCRIPTION
0=20I9
Assoclzitod Inforiom, Inc. Camol Police Depadment
VENDOR SHIP 3 CIVIC squam
24M Kontucky Avonuo TO Cumel, IN
Indianapolis, IN 46221 (319) 579
CONFIRMATION BLANKET CONTRACT I PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43-601.00
9 Each condrudion of office well $3,905.00 $3,905.00
Sub Total: $3,105.00
cu
11,
o
Send Invoice To:
Camol P611co DGp @front
Attn: Terosmm Andomon
Camol, IN 400 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Camel Police Dept. PAYMENT $3,905'00
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS AP N SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL y
SHIPPING LABELS. Ohl o� 1" gg��
o llco
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 25 51 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
|N THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
DEPT. hereby certify that the attached invoice(s), or
bill(s) is (are) hno and oonaot and that the
nna&sha|s or uen/ioee 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))
01/17/12 6495 install drywall, insulation, paint $3,165.00
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
Associated Interiors, Inc.
IN SUM OF
2435 Kentucky Avenue
Indianapolis, IN 46221
$3,165.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Encumbered I hereby certify that the attached invoice(s), or
25951 6495 I 43- 501.00 I $3,165.00
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
Thursday, January 26, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund