217830 02/26/2013 CITY OF CARMEL, INDIANA VENDOR: 294500 Page 1 of 1
's. ONE CIVIC SQUARE STEVEN R JENKINS CO INC
` CARMEL, INDIANA 46032 6680 E.21ST.STREET CHECK AMOUNT: $899.97
N
INDIANAPOLIS IN 46219
CHECK NUMBER: 217830
CHECK DATE: 2/26/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4356001 25589 179828 899 . 97 JACKETS
STEVEN R JENKINS CO INC
6680 E 21 ST ST Invoice
INDIANAPOLIS IN 46219 Date M179828
j 1-317-352-0184 El 3/201
3
Bill To Ship To
CARMEL POLICE DEPT ROBERT ROBINSON
3 CIVIC SQUARE
CARMEL,IN 46032
P.O. Number Terms Rep
25589 Net 30 SOUT
Quant... Item Code Description Price Each Amount
1 40300 CLO... BLAUER 9915Z IKE LENGTH JACKET
NAVY 2XL FOR CHRISTOPHER BAY 299.99 299.99
1 40300 CLO... B;AUER 9115Z IKE LENGTH JACKET 0.00
NAVY XL FOR LUCAS GOSSETT 299.99 299.99
1 40300 CLO... BLAUER 9915Z IKE LENGTH JACKET
NAVY XL FOR JONATHAN RICE 299.99 299.99
Sales Tax
0.00% 0.00
SHOP sr $899.97 �
jco . com Total
C 'tY ®1r INDIANA RETAIL TAX EXEMPT F GE J� Carmel CERTIFICATE NO.003120155 002 0
RCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
ONE CIVIC SQUARE 35-60000972
CARMEL, INDIANA 46032=2584 THIS NUMBER MUST APPEAR ON INVOICES,A/P
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
(`PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO.
DESCRIPTION
I
�tevon R, JenkInc Co., Inc.
DOMeI Police Department
VENDOR MM SHIP .3 CIVIC Squuo
o�$t 21st tlflt TO
Ifidla'lapolls, IN 45219 Cumol, IN 4
py
CONFIRMATION BLANKET CONTRACT (3!d)671
PAYMENT TERMS
FREIGHT
QUANTITY UNIT OF MEASURE
DESCRIPTION
Account 43-680.01 UNIT PRICE EXTENSION
3 Each Blauer 99051 Ike-length jacket w/cross
tech fabric $299.99
$899.97
Sub Total:
o� Coq
Chth B80 Luke Gomm!Jon Rica �•��`°O°°<....•���°Q Q
Send Invoice To: (
Daff"eI Pollen DepWment
Atin: Togas@ Andarsen
3 CIVIC aquas
Cafmol, IN 46W. PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT
gel po1ice Dept• PROJECT PROJECT ACCOUNT
AMOUNT
PAYMENT $ 9.97
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 PATjrHERE IS AN UNOBLIGATED BALANCE IN
C.O.D.SHIPMENTS CANNOT BE ACCEPTED. THIS APPROPRIATIOFICIENT TO PAY.FOR THE ABOVE ORDER.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY ��
i
SHIPPING LABELS. ��a¢ g
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 hlof oI ry pollee
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE
r, a
JCUMEI3S C �3ZROL No. A 9 COPY-SIGN AND RETURN TO CLERK'S OFFIC
E
VOUCHER NO.____—.WARRANT NO.______-
ALLOWED 20
IN THE SUM OF $
I
ON ACCOUNT OF APPROPRIATION FOR
4
Board Members
PO#or INVOICE NO. ACC AMOUNT I hereby certify that the attached invoice(s), or bill(s) Is (are)DEPT.# correct and that a
tt
he
a
) true an d cor
'tem
materials or services I ized thereon for
Is
made were ordered and
which charge _.
d except
I
rece ive t P
I
I _
I
i
' I
20
II
Signature
Title
I
II
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 179828 jackets/new hires $899.97
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.
Steven R. Jenkins Co., Inc. ALLOWED 20
IN SUM OF $
6680 East 21st Street
Indianapolis, IN 46219
$899.97
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25589 I 179828 I 43-560.01 I $899.97 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
Thursday, February 21, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund