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Home My WebLink About173563 06/10/2009 CITY OF CARMEL, INDIANA VENDOR: 362664 Page 1 of 1 ONE CIVIC SQUARE T3 MOTION, INC CHECK AMOUNT: $126.58 CARMEL, INDIANA 46032 2990 AIRWAY AVE AUITE A COSTA MESA CA 92626 CHECK NUMBER: 173563 CHECK DATE: 6/10/2009 DEPARTMENT A PO N UMBER IN VOICE NUMBER AMOUNT DESCRIPTIO 1110 i 4342100 11269 6.58 POSTAGE 1110 4239099 20982 11269 120.00 VEHICLE KEYS 33 MOTION, INC Phone: 714 619 -3600 �090 Airway Ave Fax: 714 619 -3611 Suite A Costa Mesa CA 92626 United States Invoice: 11269 INVOICE Page: 1 of 1 Date: 5/18/2009 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: 20892 Terms: Net 30 F.O.B: ORIGIN Sales Rep: Michael Carra Ordered: 5/18/2009 Ship Via: UPS Ground Packing Slip: 5138 Ship Date: 5/18/2009 US Dollars Line Quantity Part Number /Description Revision Unit Price Ext Price 1 6.00 100 -00100 20.00000 EA 120.00 Line Ref. 1 BLANK KEY, BLACK PLASTIC MOLDING T3 LOGO Warehouse Code: Main PO Number: 20892 Line (1) Miscellaneous Charges Description Amount 1.) Shipping 6.58 Payment Schedule Total: 126,58 USD Due Date Amount 1 6/17/2009 126.58 Total 126.58 ARForm:001:00 INDIANA RETAIL TAX EXEMPT PAGE CERTIFICATE NO. 003120155 002 0 1 Of 1 C of PURCHASE ORDER NUMBER Police Department FEDERAL EXCISE TAX EXEMPT 35- 60000972 20982 300E 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 May 11, 2009 vehicle keys VENDOR T3 Motion, Inc SHIP City of Carmel Police Department 2990 Airway Avenue, Suite A T O 3 Civic Square Costa MEsa, CA 92626 Carmel, IN 46032 ATTN: Major Jim BArlow CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION 6z Ignitionkkeys cut PA- 001 -033 20.00 120.00 y ea a Y 4 Send Invoice To: City of Carmel Pal rtz "'t s ATTN: TTresa Anderson 7 3 Civic Oquare AndmeAgnIN 46032 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT 1110 390 -99 -other miscellaneous PAYMENT A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. 1 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. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY r ./�1.; %v .I�` 1, SHIPPING LABELS. f t THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Chief Of O I iC P. AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. F g CLERK TREASURER DOCUMENT CONTROL NO. A. COPY SIGN AND RETURN TO CLERK'S OFFICE YJUCHER NO_ WARRANT NO..-...__._-- ti 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 receivedexcept 20 Signature Title t Cost distribution ledger classification if claim paid motor vehicle highway fund Prescv��,d by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) r 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. 20982F _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)) 5/18/09 11269 Dayment for keys for segway 126.58 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 T Motion, Inc. IN SUM OF 2990 Airway Avenue, Suite A Costa Mesa, CA 92626 126.58 ON ACCOUNT OF APPROPRIATION FOR p olice general fund Board Members Po# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 20982F 11269 390 -99 120.00 bill(s) is (are) true and correct and that the materials or services itemized thereon for 1110 11269 421 6.58 which charge is made were ordered and received except June 1 20 09 -b Signature Chief of Police Cost distribution ledger classification if Title claim paid motor vehicle highway fund