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Home My WebLink About172573 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 362664 Page 1 of 1 ONE CIVIC SQUARE T3 MOTION, INC i CHECK AMOUNT: $1,240.93 CARMEL, INDIANA 46032 2990 AIRWAY AVE AUITEA COSTA MESA CA 92626 CHECK NUMBER: 172573 CHECK DATE: 5/13/2009 DEPAR ACC OUNT PO NUMBER INV NUMBER AMO DESCRIPTION 1110 4351000 20107 11196 1,240.93 MOTORCYCLE PARTS T3 MOT`7N, INC Phone: 714 619 -3600 292.0 Airway Ave Fax: 714 619 -3611 SuRe Costa Mesa CA 92626 United States Invoice: 11196 M!'Na�(�iCE Page: 1 of 1 Date: 4/30/2009 Sold To: Ship To: Jim Barlow City of Carmel City of Carmel 3 Civic Square 3 Civic Square Carmel IN 46032 Carmel IN 46032 United States United States PO Number: 20107 Terms: Net 30 F.O.B: ORIGIN Sales Rep: Michael Carra Ordered: 4/29/2009 Ship Via: Bestway Packing Slip: 5071 Ship Date: 4/30/2009 US Dollars `L�nea A Quartity PartfNumberlDescript�ona` Recision F a Unit Price' Ext Price 1 1.00 BA- 011 -C25 00 1,215.00000 EA 1,215.00 Line Ref. 1 LITHIUM POLYMER POWER MODULE, 25 MILE RANGE Warehouse Code: Main PO Number: 20107 Line (1) Miscellaneous Charges Description Amount 10.) Shipping 25.93 Paument5 ed chle art Total: 1,240.93 USD sD_,ueD ,4mount 1 5/30/2009 1,240.93 Total 1,240.93 ARForm:001:00 ity ®1 i C INDIANA RETAIL TAX EXEMPT PAGE C I' CERTIFICATE NO. 003120155 002 0 O 1 PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT t 35- 60000972 2010 3.W E 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. VENDOR NO: DESCRIPTION Avrd 20, 2009 battery VENDOR T3 Motion, Inc. SHIP City of Carmel Police Dpparfttuat 2990 Airway Avenue, Suite A TO 3 Civic Square Costa Mesa, CA 92626 Carmel, IN 46032 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Quote #001896 1 BA -011 -B Power Modules Type B 1,215.00 shipping 25.93 7777777, WM OF V a .�q City of Carmel P81 DES ar x Send Invoice To: ATTNs Teresa Anderso�� 3 Civic Square Carmel, IN 46032 PLEASE INVOICE IN DUPLICATE 1,240.93 DEPARTMENT ACCOUNT PROJECT, PROJECT ACCOUNT AMOUNT 1110 510 auto repa>t #s and ma Aten ce 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 VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY d'l�L.�G�ii�t�_L ��L �I PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO 10 CLERK- TREASURER DOCUMENT CONTROL NO. A. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO.--- WARRANT NO.._____...-..-_.__..-- ALLOWED 20 i 4 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 i Title Cost distribution ledger classification it claim paid motor vehicle highway fund Prescribed by Stale 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 T3 Motion, Inc. Purchase Order No. 20107F 2990 Airway Avenue, Suite A Terms Costa Mesa, CA 92626 Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 4/30/09 11196 payment for battery 1,240.93 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 ry� VOUCHER NO. WARRANT NO. ALLOWED 20 T 3 41otion, Inc. IN SUM OF 2990 Airway Avenue, Suite A Costa Mesa, /CA 92626 1,240.93 0 0 ON ACCOUNT OF APPROPRIATION FOR 0 p olice general fun Board Me PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoic x 20107F 11196 510 1,240.93 bill(s) is (are) true and correct and th a m aterials or services itemized thereo which charge is made were ordered/ received except co I m m no c May 7 I Signature Chief of Title, Cost distribution ledger classification if xr A rk claim paid motor vehicle highway fund r