206824 02/28/2012 CITY OF CARMEL, INDIANA VENDOR: 361937 Page 1 of 1
ONE CIVIC SQUARE T B A NORTH
CARMEL, INDIANA 46032 309GRADLE DRWE CHECK AMOUNT: $549.40
CARMEL IN 46032
o �o CHECK NUMBER: 206824
CHECK DATE: 2/2812042
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4237000 26070 3KJ4985 384.68 AC COMPRESSOR
1110 4237000 3KJ7091 164.72 REPAIR PARTS
1
TBA North Invoice
309 Gradle Dr. N o. 03KJ4985
Carmel, IN 46032
317- 574 -1957 FAX: 317 -574 -1982 II II II I I III I I III II II I I II
Page 1
v 13:40:45 Feb 17 2012
CU 1318 R N Invoice NUMBER Invoice DATE PACKING SLIP �NET MS WHSE
03KJ4985 02/17/12 03RV5575001 10T H 030
BILL TO: SHIPPED TO:
CARMEL POLICE CITY GARAGE CARMEL POLICE CITY GARAGE
3 CIVIC SQUARE 3400 W 131ST
CARMEL, IN 46032 CARMEL, IN 46074
�ll�����l�l�� ,al��„I����II�����
Dept: 002 CARMEL POLICE CITY GARAGE Contact: /317- 733 -4600 Route: CARMEL/WESTFIELD Direction:
YOUR P.O. NUMBER ORDER DATE CSR SHIPPED VIA CARTONS OPER
CAR -57 02/17/12, 13:40:41 400003 JIM RATLIFF 3 CARMEL /WESTFIELD A 403
ITEM DESCRIPTION BIN UNIT ORDER BACK INV LIST CORE NET NET EXT
QTY ORDERED QTY PRICE PRICE PRICE CORE PRICE
2008 CHEVROLET IMPALA V6 -237 3.9L
D15 15- 21471 89019271 COMPRESSOR KIT -A U EA 0 0 1 675.68 0.00 384.68 0.00 384.68
TX: 010 1
TOTAL PURCHASE TOTAL LIST TOTAL MDSE TOTAL CORE FREIGHT TAX PCT TAX AMT INVOICE TOTAL PAYMENTS BALANCE DUE
384.68 675.68 384.68 0.00 0.00 0.00 384.68 0.00 384.68
2.08% service charge on past due accounts(25% per annum).
Core returns must be in original box. All new returns must
be resaleable. No return after 30 days without invoice.
r
TBA North Invoice
309 Gradle Dr. N O. 03KJ7091
Carmel, IN 46032
317 574 -1957 FAX: 317 -574 -1982 II II II I 1 I� jlll I IIII III I��
I l Page 1
09:29:20 Feb 22 2012
CUSTOMER N Invoice NUMBER Invoice DATE PACKING SLIP TERMS WHSE
318 03KJ7091 02/22/12 03RV7973001 NET 10TH 030
BILL TO: SHIPPED TO:
CARMEL POLICE CITY GARAGE CARMEL POLICE CITY GARAGE
3 CIVIC SQUARE 3400 W 131ST
CARMEL, IN 46032 CARMEL, IN 46074
IIIIIIIIII�II, Ill�llll�k�lllll�llll� 'II�IIII�IIII�I�I
Dept: 002 CARMEL POLICE CITY GARAGE Contact: /317- 733 -4600 Route: CARMELIWESTFIELD Direction:
YOUR P.O. NUMBER ORDER DATE CSR SHIPPED VIA CARTONS OPER
STOC 1 02/22/12, 09:29:19 400013 MIKE BYRD 3 CARMEL /WESTFIELD A 413
ITEM DESCRIPTION UNIT ORDER BACK INV LIST CORE NET NET EXT
BIN QTY ORDERED OTY PRICE PRICE PRICE CORE PRICE
RAF ATD1159P AT POLICE PAD SET U EA 4 0 4 92.85 0.00 41.18 0.00 164.72
TOTAL PURCHASE TOTAL LIST TOTAL MDSE TOTAL CORE FREIGHT TAX PCT TAX AMT INVOICE TOTAL .PAYMENTS BALANCE DUE
164.72 371.40 164.72 0.00 0.00 0.00 164.72 0.00 164.72
2.08 service charge on past due accounts(25 per annum).
Core returns must be in original box. All new returns must
be resaleable. No return after 30 days without invoice.
INDIANA RETAIL TAX EXEMPT PAGE
C o f,. C arm( i CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 70
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
DURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
2MM `12
YEA North Camel Police De,par Kent
VENDOR
SHIP 3 Civic Squzro
Gf dlia Drive TO Camel, IN 46fl
Camel, IN 4M (317) 571 -2M
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
A ccount UN�iTOF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42 -37®.00
9 Each A!C compressor $384.68 $384.88
Sub Total: $384.68
Lxfi
car 6 1 1�011�r�111
Send Invoice To:
Carol Palle Do,partmont
Attn: Yeas@ Andomon
3 Civic squ
Carmel, IN Al a PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. PAYMENT M.62
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 Tj PROPER SWO�P'AFFIDAVITATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CE ?jI YTHATTHEIR 15 AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPRO�fS I ION SUF l IENTTO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. hleP of Pelleo
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK- TREASURER
DOCUMENT CONTROL NO. 26070 A. P.V. COPY SIGN AND RETURN TO CLERIC'S OFFICE
VOUCHER NO._ WARRANT NO.
ALLOWED 20
IN THE SUM OF
i
u
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT #iTLE 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
2p
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
TBA North
IN SUM OF
309 Gradle Drive
Carmel, IN 46032
$549.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
26070 3KJ4985 42- 370.00 $384.68 I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1110 3KJ7091 42- 370.00 $164.72
materials or services itemized thereon for
which charge is made were ordered and
received except
Friday, February 24, 2012
Chief of Police
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))
02/17/12 3KJ4985 a/c compressor car 57 Renforth $384.68
02/22/12 3KJ7091 brake pads $164.72
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