209365 05/22/2012 a CITY OF CARMEL, INDIANA VENDOR: 366194 Page 1 of 1
ONE CIVIC SQUARE T B W INDUSTRIES
CARMEL, INDIANA 46032 PO BOX 751375 CHECK AMOUNT: $1,300.00
LAS VEGAS NV 89136 CHECK NUMBER: 209365
CHECK DATE: 5/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4356002 26137 10 -505 1,300.00 LAPEL PINS
TBW Industries Invoice
P.O. Box 751375
Las Vegas, Nevada 89136 Date Invoice
800 282 -5537 5/9/2012 10 -505
Bill To Ship To
Carmel Police Department Carmel Police Department
Mike Dixon Mike Dixon
3 Civic Square 3 Civic Square
Carmel, Indiana 46032 Cannel, IN 46032
P.O. Number Terms Rep Ship Via F.O.B. Project
Net 30 SB 5/9/2012 UPS
Quantity Item Code Description Price Each Amount
1,000 lapel pins 1 1/8 inch 3D die struck gold tone metal lapel pins with enamel 1.30 1,300.00T
color fill and clutch back (curved or flat die)
1 setup fee waived $65 die charge for an order of 1000 pins 0.00 O.00T
free UPS ground shipping
Out -of -state sale, exempt from sales tax 0.00% 0.00
I
Total $1,300.00
Cit Carm INDIANA RETAIL TAX EXEMPT PAGE
CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 26937
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
3 URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. F DESCRIPTION
W-4 `12 F
Pinsviile.com Cannol Polico Depafton$
Scott Black SHIP 3 Civic Squm
VENDOR
4 Lono Mountain Road 0240 T Cumol, IN 46032
Las Wgas, NV 69130 (397) 671-2
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43 -0.02
1000 Each iapol pins $1.34 $1,340.00
Sub Total: $1,340.00
u
X�
.a
R
?E q E
Send Invoice To:- 4.
Cumol Pollce Department
Ala Toresa Anderson
3 Civic 8quaro
Carmcl, IN 4=
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY g °S.h,J�.➢ -'-7
PURCHASE ORDER NUMBER MUST APPEAR ON ALL r �ep� g,
SHIPPING LABELS. Chief of Pollco
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK TREASURER
DOCUMENT CONTROL NO. 2 6 1 3 7 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER VV4RRANTND�____-
ALLOWED 20___
|N THE SUM OF$
ON ACCOUNT {)F APPROPRIATION FOR
Board Members
PO# or
DEPT INVOICE NO. ACCT#/TITLE AMOUNT 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 io made were ordered and
received except
uU___-
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
TBW Industries
IN SUM OF
P.O. Box 751375
Las Vegas, NV 89136
$1,300.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
26137 10 -505 I 43- 560.02 I $1,300.00 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
4 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))
05/09/12 10 -505 lapel pins $1,300.00
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