HomeMy WebLinkAbout216662 01/29/2013 a CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1
ONE CIVIC SQUARE CHILD SOURCE
CHECK AMOUNT: $854.65
CARMEL, INDIANA 46032 7001 WOOSTER PIKE
oat° MEDINAOH 44256 CHECK NUMBER: 216662
CHECK DATE: 1129/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
852 5023990 200965 148 . 52 OTHER EXPENSES
900 4359005 25590 20695 706 . 13 CAR SEATS
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cKi-1 � SS ( � tV®IltC�
Invoice Number: 0000200695
7001 Wooster Pike,Medina,OH 44256
Ph: 330.723.4739 Fax: 330.721.6799 Invoice Date: 1/14/2013
REMITTANCE ADDRESS: Invoice Due Date: 2/13/2013
WESTERN RESERVE DISTRIBUTING,INC.
dba CHILD SOURCE Customer: CARMPD
11.0. BOX 73714 Sales Order: 00001 13702
CLEVELAND,OH 44193
Tax ID 482-0563593
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CARMEL POLICE DEPARTMENT, CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 OAK RIDGE
CARMEL, IN 46032-2584 USA ATTN MAGGIE 317-819-0772
Carmel, IN 46032 USA
��C'nsu%mer P'O ";�"��,�r�--�,����*�-�.�Sh�-- -Via, .f��" ;{L F � �F O B: ' ,ta-°-t<--:.t ��- :�--�,--are ;�-�r-�•-:�-�'
25590 FEDEX GRND ORIGIN Net 30 Days
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� �_s.��..�.. ,:.. .�:..�.r_. ,, �-'�9escnpuon,,``�". �.'„`�.. :"�. ._;�.�.:t�.�tY•cShiPF?ed..4...y.,_.` ��.�f.,nit,P,rtcc - �..",�:,�.Am,,_ iiuni _�.�i:
IC068FSM ON BOARD35 INFANT CAR SEAT W/BASE 4 $ 75.0000 $ 300.00
3812198 TRIBUTE 5 CONVERTIBLE CAR SEAT 2PK 6 $ 48.9500 $ 293.70
93-209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 2 $ 47.2000 $ 94.40
93-211 FSM VOYAGER HIGHBACK(2 PER PACK) 2 $ 29.9000 $ 59.80
LAST ITEM
Tracking Numbers: 066443715749936, 066443715749943, 066443715749950, 066443715749967, 066443715749974, 06644;
Subtotal 747.90
Freight 106.75
Sales Tax 0.00
Payment/Credit Amount 0.00
E'� .: �. Bal`anee 854.65
C INDIANA RETAIL TAX EXEMPT PAGE
tY of Carmel NO.003120155 002 0
PURCHASE ORDER NUMBER
i FEDERAL EXCISE TAX EXEMPT
ONE CIVIC SQUARE 35-60000972
CARMEL, INDIANA 46032-2584 THIS NUMBER MUST APPEAR ON INVOICES,A/P
FORM APPROVED BY STATE 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.
DESCRIPTION
Child Sourea
Cafm@l Pollce Dopartmerrt
VENDOR SHIP 3 Civic Stlumm
� 7QZ)9 Wooster Pike TO
A,i'edine, OHS 442
Carmel, IN M
coNFwMnnonl BLANKET CONTRACT
PAYMENT TERMS
FREIGHT
QUANTITY UNIT OF MEASURE
DESCRIPTION
Account 00--ra.as
UNIT PRICE EXTENSION
I
4 Each On Roard35 Infant Car Seat IC068FSM
6 Each Tribute 5 Convertible Car Seat $75.00 $300.00 j
2 Each High Back S 3812198 $48.95
9 stater H=rarrt�� 8 � $293.70
2 Each VoNager H1icghbaclt $47.20 $94.40
1 Each shipping $29.00 $59.80
• ��...�„ ° $108.75 $106.75 j
•
Sub Tot W-. $854 6565
In
GNU//j�° .... •°`�
Send Invoice To:
CamOl Police Depailmo t
Attu: TemoaAnderoon
8 Civic Squ@ly
Coal, IN 420
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT
PROJECT PROJECT ACCOUNT
'amel Police Dept, AMOUNT
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PAY_ MENT • 5
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
SHIPPING INSTRUCTIONS VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
•SHIP REPAID. I HEREBY CERTIFY THPT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIAt ON SUFFICIENT PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ""- �JJ///1JJy
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY ��
SHIPPING LABELS. /
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 r
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE (.Es�iBY �P�Qll�(y�
v
5
)OCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLER '
K S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
a
I
Board Members
PO#or
PT.# INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
l
materials or services itemized thereon for
which charge is made were ordered and
received except
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i
i
20
--------___R— Signature
' -------.-_�_-_ Title
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I
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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