The URL can be used to link to this page

216643 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 360427 Page 1 of 1 ONE CIVIC SQUARE THE BOX COMPANY € CHECK AMOUNT: $286.52 CARMEL, INDIANA 46032 616 STATION DR q rod. CARMEL IN 46032 CHECK NUMBER: 216643 CHECK DATE: 1/29/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1120 4342100 CFD11013 107 . 63 POSTAGE 1110 4342100 CPD11013 123 . 51 POSTAGE 911 4342100 CPD11013 55 . 38 POSTAGE 616 Station Drive The Box Company Phone: 317-846-7467 Carmel, IN 46032 Fax: 317-846-7468 Name: Carmel Police Dept. Phone Number: 317-571-2500 Date: 1/10/2013 Address: 3 Civic Square City: Carmel State: IN. Zip: 46032 Invoice M CPD11013 Qt Description Unit Price Total IShipping Charges(attached) $ 178.89 Packaging Charges (attached) $ - P •V - $ O $ -S/� $ V $ $ $ _ $ $ , $ _m \V $ n $ $ U) $ r-. - U) $ $ Sub Total $ 178.89 o°io Discount Thank You for Your Order! After Discount 6%Sales Tax $ - Total $ 178.89 ( ' 4l � ' / r DRMS-1 4160.14, Section 4 y `J Supplement 2, General Processing C5 - ►2TD Program Enclosure 8 - Letter of Authorization to Re ove Property Date: rDLLA O From: Sgt. Ryan Jellison sposition Ser vices Jacksonville Training Coordinator oosevelt Blvd Carmel Police Department Jacksonville, FL 32212 3 Civic Square Carmel, IN 46032 Ryan Jellison the undersigned, hereby authorize I ' (PRINT NAME) I UPS to remove the below listed requisitions on my behalf. i i I (PRINT NAME) C Extent of Authority: To remove pr!Qerty. SIGNATURE OF CUSTOMER: —'�~ 7 LIST ITEM(S) by Requisition/DTID Numb (3) Image Intensifiers DTID H9DEB12028T003 NSN: 5855014333157 I a � Z /p i o_,115 _ The provisions of this public I to all Re fining Government personnel at impacted, non-impacted and non- competed sites. This publication may be mandatory or advisory to the MEO,as stipulated in or modified by the Performance Work Statement. Section 4, Supplement 2 S2-123 i BOXFRM-01(10/06) CO DEPT DATE NO PACKAGE SHIPPING REQUEST (11 1 NAME THEB®X COMPANY S CA 9A e- 7 616 Station Drive E STREET ADDRESS j Carmel,In 46032 N 3 el,-VC D CITY,STATE,ZIP E 4�3 Z (317)846-7467 FAX(317)846-7468 R 110 P NE,WORK PHONE Internet http://www.boxco.com r3!) S71-2-5-be> PKG SEND TO DESCRIPTION OF DE LAR g�oALLE NO PACKAGE CONTENTS YOU WANT ADDT INS NAME $ PKG WT $ ��} /'�' CARRIER '5 COCA.,) R. SE.uK(AA C'DMPA.vt/ '7 '// � CHARGES J STREET ADDRESS $ ADDITIONAL INSURANCE CITY,STATE,ZIP $ HANDLING /A3"/IM�A eY-15 i v �16214-ZZ 9 CHARGE NAME $ PKG WT $ CARRIER CHARGES ^ STREET ADDRESS $ ADDITIONAL L ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE NAME / PKG WT $ CARRIER. CHARGES ^ STREET ADDRESS $ ADDITIONAL 3 ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE NAME $ PKG WT $ CARRIER � CHARGES STREET ADDRESS $ ADDITIONAL 4 ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE i ATTENTION CUSTOMERS!! PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE A PACKA(�,F WHIr.H HAR A vAl I IF nve=D Tur(`AD0IC01C i-en ........r.ir �•••n� I BOXFRM-01(10/06) CO DEPT DATE NO PACKAGE SHIPPING REQUEST NAME THEBOX COMPANY I (,q(Z/►tEL PfXsc:y 616 Station Drive E STREET ADDRESS Carmel,In 46032 N 3 eAAlG S&L-A,(ZF D CITY,STATE,ZIP '/ E CA(Z f 4- /N rl03 Z (317)846-7467 FAX(317)846-7468 R HOME PHONE,WORK PHONE . Internet hitp://www.boxco.com (3/�J 57/—aspp �yAN �£1LSp.J PKG SEND TO DESCRIPTION OF DECLARED VALUE IF OVER$100 AND NO PACKAGE CONTENTS YOU WANT ADDT INS NAME TpSbJL /wT f�R-eJAT[OaAL_ $ T WT $ CARRIER AT 7N: /xi} 'D,FAX-rME,v /NA l /7 j" CHARGES STREET ADDRESS 1 i ADDITIONAL I7300 4/ ZONE INSURANCE CITY,STATE,ZIP p $ HANDLING SGOTi�7�1C� AZ SS�SS-/(003 CHARGE NAME PKG WT $ CARRIER CHARGES ^ STREET ADDRESS $ ADDITIONAL L ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE NAME / PKG WT $ CARRIER. ^ STREET ADDRESS CHARGES 3 $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING iNAME CHARGE PKG WT $ i $ CARRIER CHARGES A STREET ADDRESS 4 $ ADDITIONAL ZONE INSURANCE � CITY,STATE,ZIP $ HANDLING CHARGE i i ATTENTION CUSTOMERS!! PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE A PARKAhF WHIr.H HAC A\CAI I iF nx A=0 Twr:r•ADDICOIC i I.AIT —i 1A011— ..—.—..�.-.vrn•�- BO'/,FRM-01 (10/06) CO DEPT DATE NO PACKAGE SHIPPING REQUEST . D NAME THE OX COMPANY S Vie- e i e — A ti-,^=---- 616 Station Drive E STREET ADDRESS Carmel,In 46032 N -------------- D CITY,STATE,ZIP E (317)846-7467 FAX(317)846-7468 R HOME PHONE,WORK PHONE Internet http://www.boxco.com PKG SEND TO DESCRIPTION OF DE OVER$1D00 AND C n0 PACKAGE CONTENTS YOU WANT AOD'L INS PKG V T NAME $ S / e 3 CARRIER 1 LOS � V CHARGES 1 - — STREET ADDRESS ADDITIONAL /7 soo�L-1 rn 1 l`(�V ~ZrO-I�JE INSURANCE (CITY,ST SIP D/ � / S � HANDLING C 0 � � t/S�e e`er CHARGE NAME $ PKG vff S CARRIER CHARGES ,, STREET ADDRESS S ADDITIONAL ,� ZONE INSURANCE CITY,STATE.ZIP S HANDLING CHARGE NAME 4J PKG VlT S CARRIEP. CHARGES - STREET ADDRESS S ADDITIONAL 3 ZONE INSURANCE CITY,STATE,ZIP PiAtdCLItJG iCHARGE NAME $ PKG WT $ CARRIER CHARGES STREET ADDRESS S ADDITION AL ZONE INSURANCE (CITY,STATE.ZIP �S u HANDLING y CHARGE ATTENTION CUSTOMERS!! PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED $25.000 IN VALUE. BOXFRM-01(10/06) CO DEPT [DATE NO PACKAGE SHIPPING REQUEST -a- Q I Z I NAME THE OX COMPANY S C � � / G /,c E STREET ADDRESS 616 Station Drive Carmel, In 46032 N D CITY,STATE,ZIP E (317)846-7467 FAX(317)846-7468 R HOME PHONE,WORK PHONE Internet http://www.boxco.com PKG SEND TO DESCRIPTION OF DECLARED 1 0 AND E NO PACKAGE CONTENTS YOU WANT ADD'L INS NAME $ PKCj V1,7 $ v D/„ CARRIER I/J J(/ CHARGES ADDITIONAL J ZONE INSURANCE CITY,STATE,ZIP G $ e HANDLING S ec"ft w p- 1 p o CHARGE 0 PKG WT $ CARRIER NAME V- ^ y c( U V c) $ o CHARGES STREET ADDRESS u $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE NAME $ PKG WT $ CARRIER CHARGES 3 STREET ADDRESS $ ADDITIONAL ZONE INSURANCE $ HANDLING CITY,STATE,ZIP CHARGE PKG WT $ CARRIER NAME $ CHARGES STREET ADDRESS $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE ATTENTION CUSTOMERS!! PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED $25,000 IN VALUE. I BOXFRM-01(10/06) CO DEPT DATE NO PACKAGE SHIPPING REQUEST b c� COMPANY NAME 14AMicro� THEBOX COMPA 616 Station Drive E STREET ADDRESS C Carmel, In 46032 N 3 v I C v U A✓C F D CITY,STATE,ZIP E CMS ,,.) L4 0 3 a (317) 846-7467 FAX(317)846-7468 R HOME PHONE,WORK PHONE I Internet http://www.boxco.com 1 :57/- aS a--), VY1 J D G Y-\ PKG SEND TO DESCRIPTION OF DE LAR sD o Akio E NO PACKAGE CONTENTS YOU WANT ADDT INS NAME $ PKC'`^T $ 2 CARRIER (�'11C 3/ �� CHARGES / w STREET ADDRESS ? / 1 939 90`1'` S S(�17G ��^ � ��y+lp �1� �/ pp 0, $ ,m ADDITIONAL �V ZONE �'v!/ INSURANCE CI ,STATE,ZIP $ ' s/ CHARGE C S n y Z i5 / NAME $ PKG WT $ CARRIER CHARGES 2 STREET ADDRESS $ ADDITIONAL ZONE � INSURANCE CITY STATE,ZIP $ HANDLING I CHARGE NAME $ PKG WT $ CARRIER o CHARGES 3 STREET ADDRESS $ ADDITIONAL ZONE INSURANCE CITY STATE,ZIP $ HANDLING CHARGE i NAME PKG WT $ $ CARRIER CHARGES 4 STREET ADDRESS $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE ATTENTION CUSTOMERS!! PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM, TOTAL PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED $25,000 IN VALUE. ' 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)) 01/10/13 CPD11013 shipping charges $123.51 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 The Box Company IN SUM OF $ 616 Station Drive Carmel, IN 46032 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1110 I CPD11013 I 43-421.00 I $123.51 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the �o y� materials or services itemized thereon for ICJ' which charge is made were ordered and received except a ry 2,- Thursday, January 24, 2013 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund BOXFRM-01(10/06) PACKAGE SHIPPING REQUEST CO DEPT DATE NO l NAME THEB®X COMPANY S 616 Station Drive E STREET ADDRESS Carmel, In 46032 N D CITY,STATE,ZIP E (317)846-7467 FAX(317)846-7468 R HOME PHONE,WORK PHONE Internet http://www.boxco.com PKG DESCRIPTION OF DECLARED VALUE TO NO PACKAGE CONTENTS YOU WANT ADD'L INS NAME N $ '� � CARRIER 1 STREET ADDR CHARGES ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP ( $ \ HANDLING CHARGE NAME < ,{I— y� r $ PKG WT $ CARRIER CHARGES 2 STREET ADDRESS -- VV ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE NAME PKG WT $ $ CARRIER CHARGES 3 STREET ADDRESS $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE NAME PKG WT $ $ CARRIER CHARGES 4 STREET ADDRESS $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE ATTENTION CUSTOMERS!! PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED $25,000 IN VALUE. BOXFRM-01(10/06) CO DEPT DATE � r � NO PACKAG SHIPPING EQUEST t/ NAME THE NY s �'p� f E STREET ADDRESS 16 on e el, 032 N D CITY,STATE,ZIP E (317)846-7467 FAX(317)846-7468 R HOME PHONE,WORK PHONE Internet p: ww.boxco.com PKG SEND TO DESCRIPTION OF DECLARED 1 VALUE NO PACKAGE CONTENTS YOU WANT ADD'L INS n / /� ,'/ / PKG VvT $ CARRIER N�/IC fi�l17L��dj f/ ��AIR {OCf- 3 �Z7 & �'�llo�j�Ts $ CHARGES STREET ADDRESS rTCel $ ADDITIONAL PoAIQ SVIT,r �O ZONE INSURANCE ,CITY,STATE,ZIP v - $ HANDLING n / tI&Z f CHARGE N L L 7 PKG WT $ CARRIER NAME CHARGES 2 STREET ADDRESS $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE PKG WI $ CARRIER NAME CHARGES - 3 STREET ADDRESS $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE NAME $ PKG WT $ CARRIER CHARGES 4 STREET ADDRESS $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE ATTENTION CUSTOMERS!! PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED $25,000 IN VALUE. BOXFRM-01 (10/06) CO DEPT DATE � NO PACKAG SHIP EQUEST �—d NAME _ THAa,mel, s C n1r,C C.2� p 1 E STREET ADDRESS 4PAANY In 46032 N D CITY,STATE,ZIP E (317)846-7467 FAX(317)846-7468 R HOME PHONE,WORK PHONE Internet http://www.boxco.com PKG SEND TO DESCRIPTION OF DECLARED o ANO E NO PACKAGE CONTENTS YOU WANT ADD'L INS P CARRIER NA T $ Z� ( CHARGES Ep�2,4� Si�NA STREET ADDRESS $ ADDITIONAL n��A� !/�aR� p� O ZONE INSURANCE CITY,STATE,ZIP 7!/� n(�J (j O T� !!! $ HANDLING Okoik-S1 7 /'R /^L / _(R- 216-7 �G ! CHARGE NAME (Op(�// $ PKGVVT $ CARRIER CHARGES STREET ADDRESS $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE NAME $ PKG WT $ CARRIER CHARGES STREET ADDRESS $ ADDITIONAL 3 ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE NAME $ PKG WT $ CARRIER CHARGES w STREET ADDRESS $ ADDITIONAL 4 ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE ATTENTION CUSTOMERS!! PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED $25,000 IN VALUE. • BOXFRM-01(10106) CO DEPT DAT NO JZ PACKAGE SHIPPING REQUEST f NAME THEB®X COMPANY S Re E STREET ADDRESS 616 Station Drive N Carmel,In 46032 D CITY,STATE,ZIP E (317)846-7467 FAX(317) 846-7468 R HOME PHONE,WORK PHONE Internet http://www.boxco.com PKG DESCRIPTION OF DECLARED V 1 0 AND E SEND TO NO PACKAGE CONTENTS YOU WANT ADD'L INS _ p� '/J '/ $ PKG WT $ CARRIER NAME ' L L�04�2 �/ / �A3KC/b�T� 2 ,� CHARGES v $ ADDITIONAL STR ET ADDRESS _ -3� r r uwL� n� ^ Soli ZONE INSURANCE �-/ ! /C /✓ $ HANDLING CITY,STATE,ZIP CHARGE L10 PKG WT $ ,/ CARRIER NAME pp / p )EQ[o1Y1 /\ CHARGES STREET ADDRESS PAars ADDITIONAL S ZON INSURANCE Q AL U � �r pp -/ , $ HANDLING CITY,STATE.ZIP r UNI V FpST/ /A�I` �L O� D GJ l CHARGE PKG WT $ CARRIER NAME CHARGES $ ADDITIONAL 3 STREET ADDRESS ZONE INSURANCE $ HANDLING CITY,STATE,ZIP CHARGE NAME PKG WT S CARRIER CHARGES $ ADDITIONAL q STREET ADDRESS L� ZONE INSURANCE $ HANDLING CITY,STATE,ZIP CHARGE ATTENTION CUSTOMERS!! PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED $25,000 IN VALUE. BOXFRM-01(10/06) CO DEPT D TE 21:: PACKAGE SHIPPING REQUEST �' � / NAME THEBOX COMPANY S ( 16mil CI&I 616 Station Drive E STREET ADDRE Carmel, In 46032 N D CITY,STATE,ZIP E (317)846-7467 FAX(317)846-7468 R HOME PHONE,WORK PHONE Internet http://www.boxco.com PKG SEND TO DESCRIPTION OF DECoLAR$D 100 NO PACKAGE CONTENTS YOU WANT ADD'L INS NAME / $ P $ �j� CARRIER `DD CHARGES 1 STRE T ADDRESS $ ADDITIONAL ZONE INSURANCE CITY, T TE, I $$ HANDLING L CHARGE NA E $ PKG WT $ CARRIER CHARGES 2 STREET ADDRESS /� O ^ f� /� $ ADDITIONAL Ivi ✓j (_�I] " 1 �ll'�_ ZONE � INSURANCE CITY,STATE,ZIP I $ HANDLING CHARGE NAME c $ PKG WT $ CARRIER f 0,, Ge(9 Cpl✓m e- CHARGES 3 STREET ADDRESS /� $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE NAME $ PKG WT $ CARRIER CHARGES 4 STREET ADDRESS $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE ATTENTION CUSTOMERS!! PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED $25,000 IN VALUE. ~ BOXFRM-01(10/06) CO DEPT DATE NO PACKAGE SHIPPING REQUEST THE BOX COMPANY S NAME 616 Station Drive E STREET ADDRES Carmel,In 46032 N D CITY,STATE,ZIP E (317)846-7467 FAX(317)846-7468 R HOME PHONE,WORK PHONE Internet http://www.boxco.com PKG SEND TO DESCRIPTION OF DE LAR sDoANO E NO PACKAGE CONTENTS YOU WANT ADD'L INS NAME 4: Ff6�� n $ PKG WT $ G` CARRIER D4: i�r,�C�1/ ( CHARGES STREET ADDRESS $ ADDITIONAL 1 L J ,\ OO ZONE INSURANCE CITY,STATE, I $ j� HANDLING (. �� /� CHARGE NAME $ PKG WT $ CARRIER CHARGES 2 STREET ADDRESS $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP n/ $ HANDLING DrrCe- O ca/-M e/ • /,N/, D CHARGE NAME $ PKG WT $ CARRIER CHARGES 3 STREET ADDRESS $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE NAME PKG WT $ $ CARRIER CHARGES 4 STREET ADDRESS $ ADDITIONAL ZONE INSURANCE CITY,STATE,ZIP $ HANDLING CHARGE ATTENTION CUSTOMERS!! ■ PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED $25,000 IN VALUE. • I -------------- -------------- 616 Station Drive Carmel, IN 46032 The Box Company Phone: 317-846-7467 �I Fax: 317-846-7468 Name: Carmel Fire Department Phone Number 571-2600 Address: 2 Civic S Date: 1/10/2013 Square Fax Number City: Carmel P.O. Number er II te: IN Zip:P 46032 Invoice#: CFD11013 Descri ti Qt on Shipping Charges(attached) Unit Price Total Packaging Charge(attached) $ 107.63 $ O $ $ _ $ $ M $ (Q $ Cn $ _0 (D $ 0 $ - .- $ - - ---M Sub Total $ 107.63 Thank You for Your Order.! Discount After Discount 0% Sales Tax Total $ 107.63 )rescribed by State Board of Accounts City Form No.201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL 4n invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by Nhom, 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)) CFD11013 Shipping to return items for repair $107.63 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. The Box Company ALLOWED 20 IN SUM OF $ 616 Station Drive Carmel, IN 46032 $107.63 ON ACCOUNT OF APPROPRIATION FOR Carmel Fire Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT r Board Members 1120 I CFD11013 I 43-421.00 I $107.63 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 JAN 2 8 2013 Fire Chief Title Cost distribution ledger classification if claim paid motor vehicle highway fund