HomeMy WebLinkAbout217999 03/13/2013 CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1
ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $483.74
CARMEL, INDIANA 46032 7001 WOOSTER PIKE
MEDINAOH 44256 CHECK NUMBER: 217999
CHECK DATE: 3/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
900 4359005 25658 203301 483 . 74 CAR SEATS
oe o 0
-8l So u Invoice
UNUMMEMNEW Invoice Number: 0000203301
7001 Wooster Pike,Medina,OH 44256
Ph:330.723.4739 Fax:330.721.6799 Invoice Date: 2/27/2013
REMITTANCE ADDRESS: Invoice Due Date: 3/29/2013
WESTERN RESERVE DISTRIBUTING,INC. Customer: CARMPD
dba CHILD SOURCE
P.O.BOX 73714 Sales Order: 0000114796
CLEVELAND,OH 44193
Tax ID#82-0563593
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CARMEL POLICE DEPARTMENT,CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 OAK RIDGE RD
CARMEL, IN 46032-2584 USA Carmel, IN 46032 USA
c 7
FEDEX GRND DESTINATION Net 30 Days
.. .. Desch iian •=':s= :a= t"'S1ii d:'..;«,: Uliit Pike z '.. ',:.;'';: >x� Am un
IC068FSM ON BOARD35 INFANT CAR SEAT W/BASE 3 $ 75.0000 $ 225.00
3712198 TITAN 65 CONVERTIBLE CARSEAT 2PK 2 !, $ 58.4500 $ 116.90
3711198 TITAN 65 CONVERTIBLE CARSEAT 1PK 1 $ 58.4500 $ 58.45
---------------------- --------------------------------- ------------------------ LAST ITEM —
i
Tracking Numbers: 066443715803805, 066443715803812, 066443715803829, 066443715803836, 066443715803843
Subtotal 400.35
Freight 83.39
Sales Tax 0.00
Payment/Credit Amount 0.00
'•; ;;'eBalatice 483.74
INDIANA RETAIL TAX EXEMPT PAGE
City ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 9
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
113
(Child Source Camel Polito Department
VENDOR TOIP 3 CIVIC Squar@
7001 Wooster Pike Carmel, IN 432
Medina, OIL 44256 (317)571-2559
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 00-M.06
9 Each shipping $83,39 $83.39
Each
1 Each Than 65 C a ellibel car watt 1 pIc 71 8:rte X58.45 $58A5
2 Each Tital 65 Convertible earseat 2pk 7 21 `1;�;".„ $58.45 $116.90
3 Each On Board35 Infant Car Seat M,IC�68� $75.00 $225,04
Cub Total. $483.7
cre
INpia �``• ', yl �� sf� �.�:
Send Invoice To.
C&m0l POIICO D@P2ftMGnt
Attn:Temso Anderson
3 CIVIC Squ
Camel, IN 401 - PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. *`` `� j PAYMENT $M.74
r \ A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
S NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
`•,.,,,_,_„�� VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY �l
SHIPPING LABELS. /p y�
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE //Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. V
CLERK-TREASURER
DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
i
Board Members
or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# ! 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
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
Child Source
IN SUM OF $
7001 Wooster Pike
Medina, OH 44256
$483.74
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Grant Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25658 I 203301 I -590.05 I $483.74 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
Wednesday, March 06, 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 fr
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))
02/27/13 203301 car seats $483.74
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