216485 01/15/2013 CITY OF CARMEL, INDIANA VENDOR: 363645 Page 1 of 1
ONE CIVIC SQUARE RIMAGE CORPORATION CHECK AMOUNT: $1,932.09
CARMEL, INDIANA 46032 NW5255
PO BOX 1450 CHECK NUMBER: 216485
MINNEAPOLIS MN 55485-5255
CHECK DATE: 1/15/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 R4239099 25564 90114331 1, 932 . 09 MISC SUPPLIES
Page 1 of 1
Phone: 1-800-445-8288 12/20/2012 22:00:53
R I M A G E6 Fax: 952-944-7808
Internet: www.rimage.com
Invoice
Sold To-Party Information
CITY OF CARMEL POLICE DEPT. Invoice Number/Date 90114331 12/20/2012
3 CIVIC SQUARE Delivery Number/Date 801 6,1091 12/20/2012
CARMEL IN 46032 Sales Order Nurrt )er/Date 10064218 12/20/2012
PO Number 25564
PO Date 12/20/2012
Customer No. 120998
Ship-To-Party. Invoice Amt 1,932.09 USD
CITY OF CARMEL POLICE DEPT. Term of Payment Net due in 30 days
3 CIVIC SQUARE Incoterm FOB DESTINATION
CARMEL IN 46032 Gross Weight 34.000 LB
Carrier UPS Parcel Tracking
Bill of Lading 1Z5W19X80310615276
--- -- -- niiiaycl.uiiia�r IidCey-Uieial,ll
Customer Contact: TERESA ANDERSON
Item Material/Description Quantity Unit Price Value
10 2002161 1 EA 120.42 120.42
CMY II Ribbon E600/400 (500 prints)
One 500 print CMY ribbon for use in color printing. Requires a
retranster roll to complete the print process.
20 2001635 20 EA 88.66 1,773.20
BD-R SL Everest White (25 pack)
25 count stack of 25GB Btu-rayTM recordable optical discs optimized for
Rimage Everest thermal printers.
30 2001469 1 EA 38.47 38.47
Retransfer Roll E600/400 (500 prints)
Retransfer rolls are used with color or black print ribbons to complete
the print process.
Subtotal 1,932.09
Drop Ship 0.00
Freight 0.00
Tax 0.00
Total Invoice Amount 1,932.09
Wells Fargo Bank, N.A. Please Remit Payment to:
Minneapolis, MN Account# 4100163674 Rimage Corporation
ABA Routing # 121000248 S.W.I.F.T. WFBIUS6S NW5255 PO Box 1450
Federal ID # 41-1577970 Minneapolis, MN 55485-5255
DUNS# 15-177-2530
GSA Contract#: GS-35F-0537P Thank you for your business.
All sales of Rimage products are subject to the terms of the RIMAGE SALES TERMS AND CONDITIONS which may be found at
www.rimage.com/sales-terms.htmi. By purchasing the Rimage product(s)specified in this document, you accept and agree to the RIMAGE
SALES TERMS AND CONDITIONS. Freight Charges include taxes, duties and brokerage fees which are not refundable in the event of a return.
Rimage reserves the right to send a supplemental invoice for additional freight expenses incurred after the actual ship date.
C 'tY ®lr Carmel INDIANA RETAIL TAX EXEMPT PAGE 1l CERTIFICATE NO.0031201
55 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
ONE CIVIC SQUARE 35-60000972 2
CARMEL, INDIANA 46032-2584 THIS NUMBER MUST AP
C LFORMAPPROVED BY STATE PEAR ON INVOICES,A/P
BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO.
VENDOR NO.
9211 '12 DESCRIPTION
i �IR��gG Cat�er�tlon
VENDOR CafffIGI Pollco Dopartment
SHIP 3 Civic squa
7725 WiRahington Avenue South TO
mInneapalia, AFIN 5 C,&m8l, g IN 46��
2
j CONFIRMATION BLANKET CONTRACT (3'1'7)571.2&%
PAYMENT TERMS
IFREIGHT
f QUANTITY UNIT OF MEASURE
DESCRIPTION
Account 429-M.99 UNIT PRICE EXTENSION
1 Each C MY 11 Ribbon E600/400 (500 prints) 200216
� 1
20 Each E
D-R SL Everest Mite(25 pack) 2001635 $120,42 $120.42
1 Each Retransfer Roll E60 $88.66
0!400 (500 prints) $1,773.20
$38.47 $38.47
Sub Total:
$1,932.09
°Iry C
off• .... � � I
Send Invoice To:
Camel Police DepanmGnt �U
Attn: Tom$&Anderson I
3 Civic Square
Camel, IN 46932= PLEASE INVOICE IN DUPLICATE
DEPARTMENT
ACCOUNT PROJECT
I9nel Police ®dpi• PROJECT ACCOUNT
AMOUNT
,* PAY_ $9,932.09
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
SHIPPING INSTRUCTIONS VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
•SHIP REPAID. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. THIS APP ROP/RIIAATIIIONSUFFICIENTTTTO•PAY FOR THE ABOVE ORDER.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS. ORDERED BY i/ A �„,,,jjj✓✓✓/J
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 /q'
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE ledllof of Pollco
OCUMENT CONTROL NO. 25564 I V. COPY-SIGN CLERK-TREASURER
AND RETURN TO CLERK'S OFFICE
VOUCHER NO._ WARRANT NO.
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ALLOWED 20
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IN THE SUM OF$
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ON ACCOUNT OF APPROPRIATION FOR
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Board Members
PO#or INVOICE NO. ACCT#R1TLE 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
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which charge is made were ordered and
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received except
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Signature
Title
{ Cost distribution ledger classification it
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))
12/20/12 90114331 blu-ray discs/ribbons $1,932.09
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
Rimage Corporation
IN SUM OF $
7725 Washington Avenue South
Minneapolis, MN 55439
$1,932.09
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
Prior Year Encumbered I hereby certify that the attached invoice(s), or
25564 I 90114331 42-390.99 I $1,932.09
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, January 10, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund