208366 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 366133 Page 1 of 1
ONE CIVIC SQUARE L E S INC CHECK AMOUNT: $95.40
CARMEL, INDIANA 46032 PO BOX 47
o� b� MINNESOTA MN 55959 CHECK NUMBER: 208366
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239099 26116 679 95.40 FINGERPRINT BRUSHES
LES Inc. Invoice
PO Box 47
Minnesota City, MN 55959 Date Invoice
4/2/2012 679
Bill To Ship To
Carmel Police Dept Cannel Police Dept
3 Civic Square 3 Civic Square
Cannel, Indiana 46032 Carmel, IN 46032
P.O. Number Terms Ship Via F.O.B.
2616 Net 30 4/2/2012 UPS
Quantity Item Code Description Price Each Amount
12 4410 fingerprint brush LES 7.95 95.40T
Out -of -state sale, exempt from sales tax 0.00% 0.00
Total $95.40
Phone Fax E -mail Web Site
1- 866 -552 -2745 1- 866.554.3478 les @leswebsite.com leswebsite.com
INDIANA RETAIL TAX EXEMPT PAGE
C i ty ®f C arme l CERTIFICATE N 0 03120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 26115
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
'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
W=Al2
LES Crime Scene Solutions Carmel Police Department
VENDOR
SHIP 3 CIVIC Squam
SW Resmrvoir Road TO Camel, IN 46M
Rushford, IAN SM71 (317) 571
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-M.99
92 Each LES fingerprint brushes 4490 87.05 895.40
Stab Total: $95.40
0
0
°r
0
Send Invoice To: F
Camel Police Department
Attn: Temsa Anderson
J Chic Squam
Cannel, IN 2- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Carmel Police Dept. f PAYMENT .40
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 APPROPRI SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE Ac h l e Poli
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. L 611 6 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.—
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 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))
04/02/12 679 lab supplies $95.40
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
LES Inc
IN SUM OF
P.O. Box 47
Minnesota City, MN 55959
$95.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
26116 I 679 I 42- 390.99 I $95.40 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
Wednesday, April 18, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund