174401 07/08/2009 CITY OF CARMEL, INDIANA VENDOR: 178620 Page 1 of 1
ONE CIVIC SQUARE KUSTOM SIGNALS, INC
CHECK AMOUNT: $617.00
CARMEL, INDIANA 46032 PO BOX 411882
ATTN: ACCTS REC
o CHECK NUMBER: 174401
KANSAS CITY MO 64141 -1882
CHECK DATE: 718/2009
D EPARTMENT ACCOUNT PO N UMBER INVOICE NUMB AMOUNT DESCRI
1110 4350000 21031 393258 617.00 VAULT REPAIRS
Invoice Number 393258
Invoice
KUS SIGNALS I NC. Customer Copy
Invoice Date 06/17/09
A PUBLIC SAFETY EQUIPMENT COMPANY REMIT TO: Customer Number 16673
1010 W. Chestnut P.O. Box 947 KUSTOM SIGNALS, INC.
Chanute, KS 66720 -0947 PO BOX 411882 Order Number 150306 SR
(620) 431 -2700 Fax (620) 431 -2734 KANSAS CITY, MO 64141 -1882 Customer PO 21031
Page 1 of 1
SOLD TO
CARMEL POLICE DEPT SHIP TO
POLICE DEPT HDQTRS CARMEL POLICE DEPT
3 CIVIC SQUARE POLICE DEPT HDQTRS
CARMEL IN 46032 3 CIVIC SQUARE
CARMEL IN 46032
Net Due Date 07 /17/09 Terms net 30 Shipping UPS 33231
R �Extendecl
Quantty Part Numb °er DESCRIPTION /Serial
Shipped 3 Pr�c
1 015 0486 -OOR RECORDER VHS AG -720
Serial Number(s)
ES01418
33231
ES01418. Vault
OW 5 -13 -99
Video out is distorted. Checked both video out jacks on
vault with known good monitor; both jacks are distorted.
Video on tape is OK.
Jason Ogle 317 733 -4600 FAX 317 733 -6257
jogle @carmel.in.gov
*.,,.E ST.................
2 888 8888 -36 CS FREIGHT GROUND 65.00 130.00
INBOUND AND OUTBOUND SHIPPING CHARGES
1 015 0486 -20 RECORDER AG -720 RECONDITIONED 412.00 412.00
10 111 1111 -12 OOW Video Labor tenths of hr 7.50 75.00
OOW Video Labor tenths of hr
ES01418 W /AG720 L7WA10153 RECORDER. REPLACED
AG720 JOSA10048, (DISTORTED VIDEO). FUNCTION TESTED
CHECKED OK.
REMIT TO: FEDERAL ID 43- 1757730 Subtotal 617.00
KUSTOM SIGNALS, INC. III IIIIIIIIIIIIIIIIIII II III %Tax 0.00
PO BOX 411882
KANSAS CITY, MO 64141 -1882 TOTAL 617.00
WWW.KUSTOMSIGNALS.COM
KUSTOM SIGNALS, INC.
TERMS AND CONDITIONS
1. APPLICABILITY. Unless otherwise specified CONNECTION WITH THIS PURCHASE ORDER IS
in a written bid, quote or contract, the following terms and LIMITED TO THE AMOUNT PAID FOR THE GOODS.
conditions shall apply.
9. INDEMNIFICATION. Buyer will indemnify,
2. PRICES AND TAXES. Prices will be Kustom defend and hold Seller harmless from all losses, damages,
Signals, Inc.'s "Seller prices in effect on the date a liabilities and costs, including attorneys' fees, incurred or
purchase order is accepted by Seller, and Seller may change sustained by Seller as a result of any third party claim made
its prices at any time, in its sole discretion. All prices will against Seller, including a claim by a customer of Buyer,
be F.O.B. Chanute, Kansas, and net of any duties, sales, use arising from its negligent, reckless, willful, or intentional
or similar taxes, fees or assessments, and do not include actions in marketing and reselling the goods.
shipping, packaging or any insurance costs, all of which are
Buyer's responsibility. 10. EXPORT RULES. Buyer will not ship, transfer
or export the goods into any country or use the goods in
3. PAYMENT. Unless otherwise provided on the any manner prohibited by the United States Export
face of the invoice, payment is due net 30 days of invoice Administration Act or any other export laws, restrictions or
in US dollars. Partial payments are not permitted unless regulations (collectively the "Export Laws In addition, if
authorized in writing. Partial payments will be treated as the goods are identified as export controlled items under
non payment. Each invoice is independent from shipping the Export Laws, Buyer represents and warrants that Buyer
sequence and disputes relating to other invoices. Failure to is not a citizen, or otherwise located within, an embargoed
pay an invoice within 30 days will be considered a default. nation (including, without limitation Iran, Iraq, Syria,
Sudan, Libya, Cuba, and North Korea) and that Buyer is
4. DELIVERY AND PERFORMANCE. Delivery not otherwise prohibited under the Export Laws from
dates are approximate. Seller disclaims all liability for late receiving the goods.
or partial delivery. Seller may deliver in such lots and at
such times as is convenient for Seller. 11. MISCELLANEOUS. This purchase order,
together with any other written agreement between Buyer
5. LOSS IN TRANSIT. Risk of loss will pass to and Seller, if any: (i) is the exclusive statement of the
Buyer upon delivery of the goods to the carrier. In case of parties with respect to the subject matter and supersedes
breakage or loss in transit, Buyer will have notation of any prior or contemporaneous communications; (ii) may
not be amended except in writing executed by the parties;
same made on expense bill before paying freight. Seller and (iii) will be interpreted and enforced in accordance
may reject claims for shortages not made within 15 days of with the laws of the State of Kansas, without giving effect
Buyer's receipt of the goods. to principles of conflicts of law. This purchase order is:
(1) solely for the benefit of the parties, and no provision of
6. TERMINATION, RESTOCKING CHARGES. this purchase order will be deemed to confer upon any
Buyer may terminate this purchase order for its other person any remedy, claim, liability, reimbursement,
convenience, in whole or in part, by written, faxed or cause of action or other right. Each party consents to the
telegraphic notice at any time. If Buyer terminates this exclusive personal jurisdiction of the state and federal
purchase order for convenience, Buyer will be liable to courts located in the State of Kansas for purposes of any
Seller for Seller's reasonable costs incurred in the suit, action or other proceeding arising out of this
performance of this purchase order that Seller cannot Agreement, waives any argument that venue in any such
mitigate. Unless otherwise agreed upon in advance in forum is not convenient and agrees that the venue of any
writing by Seller, Seller may charge Buyer a 25% litigation initiated by either of them in connection with this
restocking fee, if: (a) the Buyer returns any non defective Agreement will be in either the District Court of Johnson
goods covered by this purchase order; or (b) prior to County, Kansas, or the United States District Court,
shipment, but after the goods are produced by Seller, Buyer District of Kansas. If any provision of this purchase order
cancels the order for the subject goods. is unenforceable, the remaining provisions will remain in
effect. No waiver (whether by course of dealing or
7. WARRANTY. Seller's warranty is provided otherwise) is effective unless it is made in writing and
separately. signed by the party to be charged with such waiver. Unless
otherwise specified in writing, notices must be given in
8. LIMITATION OF LIABILITY. SELLER IS writing by registered or certified mail, return receipt
NOT LIABLE FOR ANY CONSEQUENTIAL,
requested, addressed to:
INDIRECT, OR INCIDENTAL DAMAGES, OR ANY
LOST PROFITS OR LOST SAVINGS, EVEN IF A t Signals, Inc.
Attn:
SELLER REPRESENTATIVE HAS BEEN ADVISED OF At Sales Dept.
THE POSSIBILITY OF SUCH LOSS, DAMAGES, 9325 Pflumm
CLAIMS OR COSTS, NOR IS SELLER LIABLE FOR Lenexa, KS 66215
ANY CLAIM BY ANY THIRD PARTY. SELLER'S
AGGREGATE LIABILITY UNDER OR IN
INDIANA RETAIL TAX EXEMPT PAGE
C i t y o Carmel PURCHASE ORDE CERTIFICATE NO.003120155 002 0 R 1
1i R NUMBER
Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 7,10
30NF-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
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. tVENDOR NO. DESCRIPTION
June 16 2009 vault repairs
VENDOR Kustom Signals, Inc SHIP City of Carmel Maintenance Facility
P.O. Box 411882 TO 3400 West 131st Street
Cansas City, MO 64141 Westfield, IN 46074
ATTN: Jason Ogle
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
repairs to vvauld for car 75 Loveall 617.00
•.P A n
Cp
q
City of Carmel Po e r
Send Invoice To: ATTN• Teresa Anderso
3 Civic Squaae
Carmel, IN 46032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT I PROJECT PROJECT ACCOUNT AMOUNT
1110 500- equipment repatts and mainte A MENT
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. ff
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.
A4. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOL4, HER NO. WARRANT NO.
s
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
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Kustom Signals, Inc. Purchase Order No. 21031F
P.O Box 411882 Terms
Kansas City, MO 64141 -1882 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
6/17/09 393258 paymentfor vault repairs to car 75 Loveall 617.00
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
K ustbm Signals, Inc
IN SUM OF
P.O. Box 411882
Kansas City, MO 64141-1882
617.00
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
21031F 393258 500 617.00 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
June 30 2009
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund