209123 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 365197 Page 1 of 1
ONE CIVIC SQUARE EMP TECHNICAL GROUP INC CHECK AMOUNT: $995.00
CARMEL, INDIANA 46032 15309 STONY CREEK WAY
r6� t6 NOBLESVILLE IN 46060 CHECK NUMBER: 209123
CHECK DATE: 5/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4230200 26156 13095 995.00 PERFORATED ROLL
F EMP Technical Group Invoice
U REMIT TO:
15309 Stony Creek Way Date Invoice
Noblesville, IN 46060
317-776-6700 5/5/2012 13095
Bill To Ship To
Carmel Police Department Carmel Police Department
3 Civic Square 3 Civic Square
Carmel, IN 46032 Carmel, IN 46032
ATTN: ACCOUNTS PAYABLE ATTN: Robert Robinson
P.O. Number Terms Rep Ship Via F.O.B.
26156 Net 30 BV 5/5/2012 Fed Ex Ground Factory
Quantity Item Code Description U/M Price Each Class Amount
20 LB3663 -CASE Perforated roll, 6 roll pack, 100 sheets per ea 49.75 10519 995.00T
roll, priced per case.
Shipping Shipping /Handling 58.00 10519 58.00T
Sales Tax 0.00% 0.00
Thank you for your business. Total
$1,053.00
Phone Fax
317- 776 -6700 X100 317 219 -0535
INDIANA RETAIL TAX EXEMPT PAGE
C i ty ®f C arme l CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 26166
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,
692
Enterprise Technical Group Carmel Police DGpedment
VEND0FP0R SHIP 3 CIVIC squ2m
iM Stony Crook Vft TO Cartel, IN 4M
Noblesville, IN 4M (W) 6712M
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42 -D2.00
20 Each Perforated roll LE3603 $49.75 $995.00
Sub Total: $995.00
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Send Invoice To: w� F
Carmel Police Dopartmant
Attn: Temsa Anderson
3 CIVIC squm
Curet, IN 46=- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Carmel Police Dept. PAYMENT •00
�J A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATIO SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ,�f p p�
SHIPPING LABELS. f �11i4tl Ir�11Q�.1�
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 2 6 1 5 6 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO_WARRANT
NO`____-
ALLOWED 20
|N THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
0-�
Board Members
pu* or
DEPT. INVOICE NO. ACCT#/TITLE AMOUNT hereby certify t the attached invoico(s)
biU(o)ishsreA true and correct and that the
materials or services itemized thereon for
which charge io made were ordered and
received except
20____
Signature
Title
Cost �du:riuunnn ledger classification if
claim paid m^tor vehicle highway fund
VOUCHER NO. WARRANT NO.
Enterprise Technical Group ALLOWED 20
Ben IN SUM OF
15309 Stony Creek Way
Noblesville, IN 46060
$1,053.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
26156 I 13095 I 42- 302.00 I $1,053.00 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
Thursday, May 17, 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))
05/05/12 13095 e- ticket paper $1,053.00
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