208852 05/10/2012 CITY OF CARMEL, INDIANA VENDOR: 363645 Page 1 of 1
ONE CIVIC SQUARE RIMAGE CORPORATION
CARMEL, INDIANA 46032 Nw5255 CHECK AMOUNT: $2,216.60
PO BOX 1450
CHECK NUMBER: 208852
MINNEAPOLIS MN 55485 -5255
CHECK DATE: 5/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239099 26133 90102970 2,216.60 BLU -RAY MEDIA KIT
Page 1 of 1
Phone: 1- 800 -445 -8288 04/24/2012 22:05:31
R I M A G E Fax: 952 -944 -7808
Internet: www.rimage.com
Invoice
Sold -To -Party Information
CITY OF CARMEL POLICE DEPT. Invoice Number /Date 901 02970 04/24/2012
3 CIVIC SQUARE Delivery Number /Date 80148066 04/24/2012
CARMEL IN 46032 Sales Order Number /Date 10056451 04/24/2012
PO Number 26133
PO Date 04/24/2012
Customer No. 120998
Ship.-To-Part Invoice Amt 2,216.60 USD
CITY OF CARMEL POLICE DEPT. Term of Payment Net due in 30 days
3 CIVIC SQUARE Incoterm FOB DESTINATION
CARMEL IN 46032 Gross Weight 28.000 LB
Carrier UPS Parcel Tracking
Bill of Lading 1Z5W19X80310471645
Rimage Contact Tracey Dietsch
Customer Contact: TERESA ANEEPR S-0N
Item Material /Description Quantity Unit Price Value
10 2001635 20 EA 110.83 2,216.60
BD -R SL Everest White (25 pack)
Subtotal 2,216.60
Drop Ship 0.00
Freight 0.00
Tax 0.00
Total Invoice Amount 2,216.60
Wells Fargo Bank, N.A. Please Remit Payment to:
Minneapolis, MN Account 4100163674 Rimage Corporation
ABA Routing 121000248 S.W.I.F.T. WFBIUS6S NW5255 PO Box 1450
Federal ID 41- 1577970 Minneapolis, MN 55485 -5255
DUNS# 15- 177 -2530
GSA Contract GS- 35F -0537P Thank you for your business.
All sales of Rimage products are subject to the terms of the RIMAGE SALES TERMS AND CONDITIONS which may be found at
www.rimage.com /sales- terms.htmi. By purchasing the Rimage product(s) specified in this document, you accept and agree to the RIMAGE
SALES TERMS AND CONDITIONS. Freight Charges include taxes, duties and brokerage fees which are not refundable in the event of a return.
Rimage reserves the right to send a supplemental invoice for additional freight expenses incurred after the actual ship date.
INDIANA RETAIL TAX EXEMPT PAGE
C i t y ®f Ca CERTIFI CATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 25933
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. LVENDOR NO. DESCRIPTION
41%=2
Rimago Dorpor24ion Carmel Polico Department
VENDOR SHIP 3 Civic Squm
lhington Avonuo South TO Col, IN 4I
minnompolls, RAN 55439 (317) 5712
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42 M pcl L; C�
20 Each Rimago E000 ®lu-W modes 0 0-
Sub Tot@l: x,979.00
e� �A
J a
Send Invoice To: 2
CwmGl Police Do partmont
Attn: Tomsm Andoraon
Carmel, IN 2- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ."ACCOUNT PROJECT PROJECT, AMOUNT
srmel Police Dept. PAYMENT '•�+v
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 fHAT THEREIS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROP PU> CfENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. #Chl 6Q Police
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
IOCUMENT CONTROL NO. 26133 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))
04/24/12 90102970 DVD's $2,216.60
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
Rimage Corporation
IN SUM OF
7725 Washington Avenue South
Minneapolis, MN 55439
$2,216.60
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
26133_ I 90102970 I 42- 390.99 I $2,216.60 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, May 02, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund