214433 11/07/2012 CITY OF CARMEL, INDIANA VENDOR: 294500 Page 1 of 1
0 ONE CIVIC SQUARE STEVEN R JENKINS CO INC CHECK AMOUNT: $299.99
CARMEL, INDIANA 46032 6680 E 21ST.STREET
o� INDIANAPOLIS IN 46219 CHECK NUMBER: 214433
CHECK DATE: 11/712012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4356001 25483 163085 299 . 99 JACKET
STEVEN R JENKINS CO INC Invoice
6680 E 21ST ST
INDIANAPOLIS IN 46219 Date nvoice#
1-317-352-0184 10/19/2012 163085
Bill To Ship To
CARMEL POLICE DEPT PICKED UP BY JUAN NAVARRETE
3 CIVIC SQUARE
CARMEL,IN 46032
P.O. Number Terms Rep
Net 30 SOUT
Quant... Item Code Description Price Each Amount
1 40300 CLO... BLAUER 9905Z JACKET 299.99 299.99
Sales Tax 0.00% 0.00
$299.99
SHOP sr jco . corm Total
f� ��sane INDIANA RETAIL TAX EXEMPT PAGE
City o Jl � CERTIFICATE NO.003120155 002 0
Y PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 26483
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
W24 M212
stay @n It Jonking Co., Inc. Cats Police Department
VENDOR SHIP Civic squarth
TO
am East 21st Street Camel, IN 4 '
Indianapoli2, W M-19 (W)571-2%9
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43-660.01
1 Each Blaiaer 99055 Ike4angth jacket w/cress $274.99 $274.99
teal fabric
Sub'fatal: $$274.99
ti. •S Y. fA Sip 18•@. ..
"`•' ®�` SS• r� . yam, �•
Juan Navarreto `.?
Send Invoice To:
Carmel Police Department
Attn: Teresa Anderson
Camel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cartel Police Dept. PAYMENT $274.99
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
•SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. d
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY : ^r.Z//
SHIPPING LABELS. I/ Chief of Paiie@
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
.J A
DOCUMENT CONTROL NO. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
f '
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or
DEPT.# INVOICE NO. ACCT#/TITLE AMOUNT 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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Steven R. Jenkins Co., Inc.
IN SUM OF $
6680 East 21st Street
Indianapolis, IN 46219
$299.99
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25483 163085 43-560.01 $299.99
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, November 01, 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))
10/19/12 163085 blauer jacket/Navarrete $299.99
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