211355 07/31/2012 CITY OF CARMEL, INDIANA VENDOR: 354288 Page 1 of 1
0� ONE CIVIC SQUARE KIPP BROTHERS
4924 RELIABLE PARKWAY CHECK AMOUNT: $136.00
®4 CARMEL, INDIANA 46032
CHICAGO IL 60689-0049 CHECK NUMBER: 211355
OM
CHECK DATE: 7/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4345002 26211 971662 136 . 00 PROMO ITEMS
KIPP BROTHERS �,/""� - INVOICE
351 W. MUSKEGON DRIVE °p
GREENFIELD, IN 46140
� Remit To:
TOLL FREE 800-428-1153 FAX 800-832-5477 %
r Kipp Brothers -
www.kipptoys.com °ys"0� 5��5`"� Number 1971662
wxw.kipptoys,<om 4924 Reliable Parkway
Chicago,II, 60686-0049 Date 1 07/13/2012
Page ,1
Sold To: To: L PO_LICF- PARTMENT
CARMEL POLICE DEPARTMENT A�W4
ANN GALLAGHER la 3 CIVIC SQ
3 CIVIC SQ Rt tit L,IN 46032-2584
4
CARMEL, IN 46032-258 . /
Reference # Shipped.' Salesperson Terms Account Doc #' Wh Ship Via
26211 07/13/12 AJO OPEN ACCOUNT 244580 889123 01 UPS GROUND
Item Description Ordered Shipped Backordrd UM Price UM, Extension
28286 USA SLAP BRACELET 20 0 20 DZ 4.20 DZ .00
27757 2 OZ BUBBLES BOTTLE 20 20 0 DZ 2.40 DZ 48.00
NA 4589 US FLAG FLIP STICKS 8 8 0 BG 9.00 BG 72.00
BG=72EA
TRACK# 1 Z2AT5400375683127
TRACK# 1Z2AT5400375029736
TRACK# 1Z2AT5400375392745
YOUR CUSTOMER CODE IS: 244580 Merchandise Misc .Discount Tax' 'Freight .�' Total Due'
PLEASE USE THIS CODE WHEN
PLACING AN ORDER OR INQUIRING 120.00 .00 .00 .00 16.00 136.00
ABOUT YOUR ACCOUNT.
THANK YOU FOR YOUR ORDER.
***BALANCE DUE***
Your Credit Balance can be applied to your next order or refunded on request.No merchandise accepted for credit without our authorization.Report all errors within 10 days.
... Last Page
City /�° Carmel INDIANA RETAIL TAX EXEMPT PAGE
®,Jlr CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 99
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
MM2
Kipp Brothorz CumGI Pollco DGpaitmon4
VENDOR SHIP 3 CIVIC equ2m
4124 Rollablo ParkwW TO Co9ml, IN 46M
Chien @go, IL 4)= (397)679
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
Account ��,gUNIITs�OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43 1.02
9 Each discount ($22.40) ($22.40)
20 Each USA Slop Bracelets 28286 $4.20 $84.00
20 Each 2 oz Variety Bubbles 2 57 $2.80 : $56.00.
8 Each US Dag clip sticks R4e480 $90.80 $86.40 "
At
Sub Total: $204.00 y'
Send Invoice To: j
Cmmel PollcG DGpa t mnt
Attn:To ms,a Andamon
3 Civic Squam
Cwmol, IN 4M- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
armei Police Dept. PAYMENT M.00
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS •,I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
•SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. �a �
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE' } Chloe o?Pollco
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
IOCUMENT CONTROL NO. 2-6211 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
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))
07/13/12 971662 promotional items $136.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Kipp Brothers
IN SUM OF $
4924 Reliable Parkway
Chicago, IL 60686-0049
$136.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
26211 I 971662 I 43-450.02 I $136.00 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, July 26, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund