212425 08/29/2012 ,F CITY OF CARMEL, INDIANA VENDOR: 364574 Page 1 of 1
ONE CIVIC SQUARE E M P TECHNICAL GROUP CHECK AMOUNT: $1,060.00
CARMEL, INDIANA 46032 15309 STONY CREEK WAY
+. NOBLESVILLE IN 46060
CHECK NUMBER: 212425
CHECK DATE: 8/29/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4342100 14274 65 . 00 POSTAGE
1110 4230200 26237 14274 995 . 00 20 PERFORATED ROLLS
a= ° _ Invoice
REMIT TO:
r 15309 Stony Creek Way Date Invoice#
Noblesville,IN 46060
317-776-6700
8/23/2012 14274
TECHNICAL
GROUP
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: Teresa Anderson
P.O. Number Terms Rep Ship Via F.O.B.
26237 Net 30 BV 8/22/2012 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 11474 995.00T
roll,priced per case.
Shipping Shipping/Handling 65.00 11474 65.00T
Sales Tax 0.00% 0.00
Thank you for your business. Total 1 $1,060.00
Phone# Fax#
317-776-6700 317-219-0535
CA_ INDIANA RETAIL TAX EXEMPT PAGE
ilyOf Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 2M
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.
3URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
GtW2092
Entorpr1so` ochnlcal rDroup Carol Police Dopzftmsnt
VENDOR@on TOIP 3 Civic Squad
IM Stony Crook Way Carmel, IN 4mv
NoblGsbllle, IN 4M 591 9
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
,g QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42 .00
20 Each Perforated roll LB3663 $49.75 $995.00
Sub Total: $995.00
Send Invoice To: 11t'E
C@mol Police Dopartmont
Attn:TGrusa Anderson
3 Civic SquM
C@rmsl, IN 46032= PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
Carmel Police Dept. PAYMENT •�
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
\_l NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PRO DER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY((((((pppp�HFAT HERE IS AN UNOBLIGATED BALANCE IN
•SHIP REPAID.
THIS APPROPRRN FFICIENT TO PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. �} g
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE Ia o
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL No- 2-6- 237 A.P.V. COPY-SIGN AND RETURN TO CLERIC'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#ITITLE 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))
08/23/12 14274 shipping charges $65.00
08/23/12 14274 e-ticket paper $995.00
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
Enterprise Technical Group
Ben IN SUM OF $
15309 Stony Creek Way
Noblesville, IN 46060
$1,060.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1110 14274 43-421.00 $65.00 I hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
26237 14274 42-302.00 $995.00
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday, August 23, 2012
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund