206371 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 00350487 Page 1 of 1
ONE CIVIC SQUARE NEUTRON INDUSTRIES CHECK AMOUNT: $145.71
4• �io. CARMEL, INDIANA 46032 7107 N BLACK CANYON HIGHWAY
PHOENIX AZ 85021 CHECK NUMBER: 206371
CHECK DATE: 2114/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239099 26052 95509496 145.71 MISC SUPPLIES
Invoice PAGE 1
Ao D*1G**r.*q***uim"" h
A Division of State Industrial Products X: r)oI4:ffi3a'&::
o 7107 North Black Canyon Highway 95509496 01/31/2012 03/01/2012
NEUTRON Phoenix, Arizona 85021-7619 If you would like to receive your invoice via tax, please
Phone: 800-421-8481 Fax: 877-646-7337 contact our Customer Service Department.
Nwillo 602-864-0090 We have no Fax number on file.
Our Customer Service Phone number is: 1-800-421-8481
17986656-29203-USASC-955197010-0374-6x9 1/1 SHIP TO:
Customer No.: 226203 CITY OF CARMEL
CITY OF CARMEL
1 CIVIC SQUARE 1 CIVIC SQUARE
CARMEL IN 46032 CARMEL, IN 46032
Customer P.O.: PM 26052 Sales Order: 4326580 Delivery: 801
Your Account Manager: 90310250 CANDIE WILSON I Taxable: N
�W�i
'h
.0
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0 1 AUTO REFILL NI-712 ORANGE LITE DZ7.25 0 129.
THAN OU FOR YOUR CRDER. WE APPRECIATE YOUR BUSINESS!
1 IMPORTANT: Please return remittance portion
of invoice with your payment, To assure proper
i p I n g&P r 6 6
credit to your account, ALWAYS include your Sh ax T
customer number, invoice number, and amount 1
45-71
P aid with our remittance. 129. 16.71 0.00
I
C 0 t 1: 1i INDIANA RETAIL TAX EXEMPT PAGE
1 of Carmel CERTIFICATE NO. 003120155 002 0 l PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 22
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE' BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
V2712012
Neutron Industries Otnml Polico Department
VENDOR
SHIP 3 Civic Squars
7107 N. Slatch Canyon big" TO Carml, IN 481M
PboonIx, A2 X29
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
Accou QUANTITY y I UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42 .N
9 Each NI -792 Orange, Bog can 17047 $0.00 $0.00
1 Each 2417 dispenser 104899 $0.00 $0.00
1 Each Pdi 712 Orange Lit ®,12 cons 10$ 2, $129.00 $129.00
Bub Total: $929.00
a.
blY
Send Invoice To:
CwmGi Polico Depaitmw&
Attn: Teem Anderson
3 Civic 8quam
Czrmol, IN 40032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
CarYnel ®lice Dept. PAYMENT $129.00
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 CERI YI6T THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS AP�RIA O UFFI�TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. �y
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Ijl of I�allco
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER X
DOCUMENT CONTROL NO. 2 6 ®5 2 A.P.V. COPY -SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
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))
01/31/12 95509496 lab supplies $145.71
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. WARRANT NO.
ALLOWED 20
Neutron Industries
IN SUM OF
7107 N. Black Canyon Highway
Phoenix, AZ 85021
$145.71
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
26052 I 95509496 I 42- 390.99 I $145.71 1 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
Thursday February 09, 2012
Chief of Pol
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund