HomeMy WebLinkAbout213195 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 362664 Page 1 of 1
4` ONE CIVIC SQUARE T3 MOTION, INC
a CARMEL, INDIANA 46032 2990 AIRWAY AVE AUITEA CHECK AMOUNT: $242.94
COSTA MESA CA 92626 CHECK NUMBER: 213195
CHECK DATE: 9/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350000 25462 19732 242 . 94 EQUIP REPAIRS
T3 MOTION, INC Phone: 714-619-3600
2990 Airway Ave Fax. 714-619-3611
Suite A
Costa Mesa CA 92626
United States
Invoice: 19732 ; :; ;�
t. T _��-- "� Page: 1 of 2
� .IN�/O.IC.E�:� � f
Date: 8/29/2012
Sold To: Ship To:
Jim Barlow
City of Carmel City of Carmel
Attn: Teresa Anderson Attn: Teresa Anderson
3 Civic Square 3 Civic Square
Carmel IN 46032 Carmel IN 46032
PO Number: 25462 Terms: Net 30 F.O.B: ORIGIN
Ordered: 8/29/2012 Ship Via: UPS Red (Overnigh
Packing Slip: 12711 Ship Date: 8/29/2012
SO: 14404
US Dollars
Line, _=- Quantit . 'Part'N;umiiii/ .escri tiori . - ::Revision, .,;::..-:`- ;Unit Pr'ice.;• _ EztPrice
r.
._ _.__._.. ..... __. .
1 1.00 100-50000 52.25000 EA 52.25
Line Ref. 1 FRONT WHEEL
Warehouse Code:Main
PO Number: 25462
2 1.00 025-00045 00 1.77000 EA 1.77
Line Ref. 2 CABLE ASSY, TAIL LIGHT LED BOARD
Warehouse Code:Main
PO Number: 25462
3 1.00 023-00029 00 55.70000 EA 55.70
Line Ref. 3 SUB ASSY, I-SERIES THUMB SWITCH
Warehouse Code:Main
PO Number: 25462
4 1.00 SH-001-001 114.40000 EA, 114.40
Line Ref. 4 SHIPPING & HANDLING (UPS 3PM Delivery)
Warehouse Code:Main
PO Number: 25462
5 1.00 020-00038-C 00 15.00000 EA 15.00
Line Ref. 5 SUB ASSY, G-BASIC TAIL LIGHT BOARD, RED-BLUE
Warehouse Code:Main
PO Number: 25462
6 1.00 500-00107 3.82000 EA 3.82
Line Ref. 6 TAIL LIGHT PERABOLA LH
Warehouse Code:Main
PO Number: 25462
ARForm 001 00
T3 MOTION, INC Phone: 714-619-3600
2990 Airway Ave Fax: 714-619-3611
Suite A
Costa Mesa CA 92626
United States
Invoice: 19732 . -< -°.
Date: 8/29/2012
~} ��
14404
. L'ine = Quantity Fart Numbe"r/pescr,iptio,n;: Revision:X =_' Unit;Rrice= - Ext Price
.. .:.
Pa u !Vh enfiSched
Total:
242.94 USDj
'Due=`Date m_ount
y1 9/28/2012 242.941
LTotal 242.94I
ARForm 001 00
Cny O ®� Carmel INDIANA RENO.0031 EXEMPT PAGE
CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
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
X12
T3 Motion, Inc. Camel Police Department ,
VENDOR TOHIP 3 Civic Squam
2W Alm ay Avenuo Camel, IN 4
Costa Mesa, CA'926M (317)571-20D
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF ESCRIPTION UNIT PRICE EXTENSION
Account 434M,00
Each
1 Each Front Tire Rile 100-50000 $52.25 $52.25
1 Each Sub Assy,G-Basic Tell Light Board ' ( t $20.63 $20.63
1 Each Thurnbswitch,Saab-Assy5 position . :,01 X55.70 X55.?0
I Each shipping charges : n r. '� $114.40 $114.40
Stab Total, '�242.g8
Send Invoice To:
Can-not Police Department
Attn:Temsa Anderson
3 Civic Squab ,
Cartel, IN 4i=6 PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT T�, PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. i;� PAYMENT $242,98
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
SHIP REPAID.
�,� r
f �ti
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ;
ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL �,,..•,,� .�
SHIPPING LABELS. pa
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE ,Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ``•'� 5
254 CLERK-TREASURER
DOCUMENT CONTROL NO. A. • COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO.--_-_._---.WARRANT
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF-APPROPRIATION FOR
a
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
20
it
_^ 1
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
T3 Motion, Inc.
IN SUM OF $
2990 Airway Avenue
Costa Mesa, CA 92626
$242.94
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25462 I 19732 I 43-500.00 I $242.94 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, September 19, 2012
L.
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))
08/29/12 19732 T3 repairs $242.94
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