HomeMy WebLinkAbout216867 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 273975 Page 1 of 1
ONE CIVIC SQUARE ROBERT'S DISTRIBUTORS, INC CHECK AMOUNT: $253.76
=o CARMEL, INDIANA 46032 255 S.MERIDIAN ST
INDIANAPOLIS IN 46225 CHECK NUMBER: 216867
CHECK DATE: 1/2912013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239099 25613 5-1241574 253 . 76 FILTERS/KITS/CARDS
0 berts-®
Invoice
ROBERTS CARMEL Ticket#: 5-1241574
12761 OLD MERIDIAN ST
Ticket date: 1/23/13
CARMEL, IN 46032
Station: 5
317-818-9800 Fax 317-818-!400 FE4 32-0000112
Orig ord#: 5-1-1
241574
Sold to: CARMEL POLICE DEPT Ship to:
3 CIVIC SQUARE
CARMEL, IN 46032
317-571-2500
Customer#: CAPD Ship date: Purchase Order-#: Ship-via code:
Sls rep: 53 Location: Terms:. NET 30 DAYS
Quantity Item# Description Manuf Part-# Price Unit flag Ext prc
4 HOY-00263CE HOY-58MM NXT UV A-NXT58UV 15.00 EACH 60.00
4 HOY-00159FE HOY-52MI ,NXT UV A-NXT52UV 13.00 EACH 52.00
2 SAN-02076 16gb SDSDX2-016G-X46 49.97 EACH 99.94
6 PRO-14060 PRO-OPTICCLEAN DLX CA 4879 13OX 6.97 EACH 41.82
Payments,' Amount
ACCTS REC _ 253.76
Total Charges: 253.76
Drawer: 501 User: 15 Total line items: 4 Sub Total: 253.76
Tax: 0.00
Total: 253.76
Tax: 0.00
Authorized Signature-
PLEASE
P F -M THIS INVOICE
We Appreciate bur Business
TOTAL AMOUNT DUE: 253.76
Please REMIT to: 255 S:Meridian St., Indianapolis, IN 46225
CINDIANA RETAIL TAX EXEMPT PAGE
iotT o Carmel CERTIFICATE NO.003120155 002 0 JL 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,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
VW20`13
Robertz"DistribIw toss LP Carmel Police Department
VENDOR TOHIP 3 Civic quart
2 S. Matldlan 6treat Carmel, IN
Indianapolis, IN 46226 (317)571
CONFIRMATION B=UNIT PAYMENTTERMS FREIGHT
QUANTITY DESCRIPTION UNIT PRICE EXTENSION
Account 42-3.
4 Each UV fillers HOY-00263CE $15.00 $60.00
6 Each cleaning kits PRO-14060 $6.97 $41.82
2 Each memory cards t�20�6M�_. $49.97 $99.94
4 Each W filters 0 `= OiS $13»00 $52»00
Sub Total: $263.76
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Send Invoice To:
Carmel Police Department
Attn: Teresa Ander3on
3 Civic Square
Carmel, IN 46332. PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. 's PAYMENT $253»76
I A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY "'✓ fi !0"�"
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE pl%H&O
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. T
Z 5 6 CLERK-TREASURER
DOCUMENT-CONTROL NO. A. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
_ 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 except.-- - --- --- -- ---------- --
20
................................................................................................ .................................................................
Signature
.................................. .................................................................................................................--.........
Title
i
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
Roberts' Distributors LP
IN SUM OF $
255 S. Meridian Street
Indianapolis, IN 46225
$253.76
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25613 I 5-1241574 I 42-390.99 I $253.76 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
Friday, January 25, 2013
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))
01/23/13 5-1241574 lab supplies $253.76
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