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209493 06/05/2012 CITY OF CARMEL, INDIANA VENDOR: 362614 Page 1 of 1 ONE CIVIC SQUARE BGI FITNESS CHECK AMOUNT: $353.73 CARMEL, INDIANA 46032 4340 EAST 82ND ST o �a INDIANAPOLIS IN 46250 CHECK NUMBER: 209493 CHECK DATE: 6/5/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4238000 308930 353.73 SMALL TOOLS MINOR E BGI Fitness Work Order 86183 BGI Fitness PLEASE NOTE OUR NEW ADDRESS INVOICE 308930 Bicycle Garage Indy Account 000100024799 nd Page: 1 of 1 4340 E. 82 Street Date: 5/18/2012 Indianapolis, IN 46250 Time: 9:52:56 AM Cashier: LK Register 1012 Reference: COM /PO #26135 Comment: PO #26135 Bill To: Carmel Police Department Ship To: Carmel Police Department Carmel Police Department Carmel Police Department 3 Civic Sq 3 Civic Sq Carmel, IN 46032 -2584 Carmel, IN 46032 -2584 317 571 -2533 Alt= 317 409 5866 -Mike Pitman Rep Item Lookup Code Descnptron �v E� Quantty r Pr7ce Extended JA SO_10_3175712533_6 ZF -Park 10mm Hex Tool 1 $10.99 $10.99 QBP# TL8295 Discount ($2.20) ($2.20) JA SO_10_3175712533_7 ZF- Bondhaus 1.5 -8mm Allen Set 1 $13.99 $13.99 QBP# TL8001 Discount ($2.80) ($2.80) JA SO_10_3175712533_8 ZF -Park Needle Nose Pliers 1 $24.99 $24.99 QBP# TL8645 Discount ($5.00) ($5.00) JA SO_10_3175712533_9 ZF -Park 12" Adj Wrench 1 $33.99 $33.99 QBP# TL8309 Discount ($6.80) ($6.80) JA SO_10_3175712533_10 ZF -Park Combo Wrenches 6 -17 1 $79.99 $79.99 QBP# TL8300 Discount ($16.00) ($16.00) JA SO_10_3175712533_11 ZF -Park Floor Pump 1 $47.99 $47.99 QBP# PU8600 Discount ($9.60) ($9.60) JA SO_10_3175712533_12 ZF -Park Spoke Tension Meter 1 $74.99 $74.99 QBP# TL7426 Discount ($15.00) ($15.00) JA SO_10_3175712533_13 ZF -Park Consumer Truing Stand 1 $127.99 $127.99 QBP# TL7098 Discount ($25.60) JA 99900 Thanks for Your Bu §inessi 1� $0.00 $0.00 Lavina Kautz Thanks for choosing BGI. Sub Total $331.92 Sales Tax $0.00 Billing: 317.842.4140 x570 Service: 317.579.7933 BGI Pass Through of Manf Freight Charges $21.81 Total $353.73 www.bgifitness.com infon @bgindy.com i 111181 IIIII 111111111111111IIIII 11111111 308930 INDIANA RETAIL TAX EXEMPT PAGE C u anal CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER lvs Y FEDERAL EXCISE TAX EXEMPT�� 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. PURCHASE ORDER DATE DATE REQUIRED A REQUISITION NO. VENDOR NO. DESCRIPTION 51 2 901 Fitness Cumal Police Department VENDO CorporAlon Drive SHIP 3 Civic Squaae+a TO Cmrmol, IN Indlanepolls, IN 4 (317)671 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT A ccoun t 42 TIITYYUNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION 1 Each ZF -Park 10 mm Hai tool TL8295 $10.99 $10.99 1 Each ZF- Bandhaaus 1.5 -8mm Alen set TL8001 $13.99 $13.99 1 Each ZF -Park Weedle Nose pliers T1L80 $24.99 $24.99 1 Each ZF -Park 12 adjustable wrench T�83Q9 $33.99 $33.99 1 Each ZF -Park combo wrenches P 830 ag`� $Fg.gg 9.99 1 Each ZF -Park Floor pump �U8000'`; X17.99 $47.99 1 Each ZF -Park Spoke Tension m0tir T1.7426 p $74.99 $74.99 1 Each ZF -Park Consumer Truro s1nda q A T17098 $12 $127.99 1 Each discount ($83.00) ($83.00) 1 Each shipping charges $21.81 $21.81 I hid Sub Total: $353.73 J r Send Invoice To: j w Q5 i E Carmol Police Depa>lmen4 Attn: Toros@ Andaruon 3 Civic Squm Caarmol, IN 4 PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dept. PAYMENT M3.73 A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT T ERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATIO SUICIENT TO PAY FOR THE ABOVE ORDER. Iwo C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE of Pollco AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK TREASURER DOCUMENT CONTROL NO.26175 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. 'WARRANT NO�____ ALLOWED 20 |N THE SUM 0F$ ON ACCOUNT OF APPROPRIATION FOR Board Members D po 9' INVOICE NO, ACCT#/TlTLE AMOUNT hereby certify that the attached invoioe(e),nr bill(s) is (ane) true and correct and that the materials or services itemized thereon for which charge ia made were ordered and received except, 28____ 8�n�um Title Cost distribution ledger if claim paiumom,v°molehighwmyfund (02 �I'y VOUCHER NC WARRANT N ALLOWED 20 BGI Fitness G' 4,0 u IN SUM OF Indianapolis, IN 46266 $353.73 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 26175 I 308930 I 42- 380.00 I $353.73 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 30, 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)) 05/18/12 308930 bicycle tools $353.73 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