211011 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 252700 Page 1 of 1
`l. ONE CIVIC SQUARE PRO-SHOT PRODUCTS, INC
0 CHECK AMOUNT: $225.93
CARMEL, INDIANA 46032 PO BOX 763
TAYLORVILLE IL 62568 CHECK NUMBER: 211011
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239010 26204 34677 225 . 93 CLEANING SUPPLIES
A . O Invoice
Bill Date Customer# Invoice#
P.O. Box 763 6/27/2012 IN 1030 34677
Taylorville, IL 62568
Bill To
:Ship To
CITY OF CARMEL POLICE DEPT.
ATTN:SGT JELLISON
CITY OF CARMEL POLICE DEPT, 3 CIVIC SQ.
ATTN:TERESA ANDERSON CARMEL, IN 46032
3 CIVIC SQ. USA
CARMEL IN 46032
P;O. Number Terms Rep Group Ship,Date Ua F.O.B.
062712 Net 30 Days NA 6/27/2012 UPS GROUND TAYLORVILLEIL
Item# ' Quantity Description Price Each' Back Order Amount
3-500 20 12-16-Gauge 3" SQ. 500CT. 10.58 211.60
UPS Shipped On: 06/27/2012 Tracking#: 14.33 14.33
IZ7689670367681444
Sales Tax(7.0%) $0.00
Phone# Fax# I E-mail Web Site,` ,
(217)824-9133 (217)824-8861 service @proshotproducts.com www.proshotproducts.com Total $225.93
DD
INDIANA RETAIL TAX EXEMPT PAGE
City ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
e#
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 REQUISITION NO. VENDOR NO. DESCRIPTION
6t2Is1�092
Pro Shot Products Cool Police Department
VENDOR
SHIP 3 CIVIC Squam
P.C. Bon M TO Cmmol, IN 460
Taylorville, IL 625M (317)671
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-M.10
r 9 Each cleaning supplies $184.00 $184.00
Sub Total: $184.00
SiO,M y Y-�n a b. SSSSl
Send Invoice To:
Carol Police DopoitmGnt
Attn:Terosa Anderson
J CIVIC squaw
CwmGI, IN 46M2- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carrel Police Dept. PAYMENT $184.00
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY R IFYTHATTHERE IS AN UNOBLIGATED BALANCE IN
• SHIP REPAID.
THIS AP IATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE ChIGf of Police 4
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 2 6 2 O CLERK-TREASURER
A
A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. __.WARRANT
ALLOWED 20
IN THE SUM OF$
$
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
........................................................................ -.-..._........-...... -........--..........._..
----7--- ---..
Signature
...............................................-...._..-... ......-..........-.........................-.....--.-..: ........-............- —
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund .
VOUCHER NO. WARRANT NO.
ALLOWED 20
Pro Shot Products
IN SUM OF $
P.O. Box 763
Taylorville, IL 62568
$225.93
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
T
26204 34677 42-390.10 $225.93
I hereby certify that the attached invoice(s), or
I
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, July 12, 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))
06/27/12 34677 weapon cleaning supplies $225.93
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