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Home My WebLink About218413 03/25/2013 ,a ,\f CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1 ONE CIVIC SQUARE CHILD SOURCE CARMEL, INDIANA 46032 7001 WOOSTER PIKE CHECK AMOUNT: $2,041.30 MEDINAOH 44256 CHECK NUMBER: 218413 CHECK DATE: 3125/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 852 5023990 203933 42 . 29 OTHER EXPENSES 900 4359005 25661 203933 516 . 26 CAR SEATS 852 5023990 25670 203934 1, 482 . 75 CAR SEATS ch s0 �� Invoice o6 Invoice Number: 0000203934 7001 Wooster Pike, Medina,0I-1 44256 Ph:330.723.4739 Fax:330.721.6799 Invoice Date: 3/11/2013 REMITTANCE ADDRESS: Invoice Due Date: 4/10/2013 WESTERN RESERVE DISTRIBUTING, INC. Customer: CARMPD dba CHILD SOURCE P.O. BOX 73714 Sales Order: 0000115068 CLEVELAND,OH 44193 Tax 11)#82-0563593 CARMEL POLICE DEPARTMENT,CITY CARMEL POLICE DEPARTMENT 3 CIVIC SQUARE 3 CIVIC SQUARE CARMEL, IN 46032-2584 USA 317-571-2559 Carmel, IN 46032 USA = k G.ustc�mertF'.®.r., w i *: Shtp Via ,. h � , � O:B., �. 25670 FEDEX GRND ORIGIN Net 30 Days 1Eem Des ri"tion CtySli`i w_ed, U.nit Puce` Amoant. 61472.65 CHICCO KEY FIT 30#ADVENTURE INFANT SEAT 10 $ 139.4500 $ 1,394.50 ------------- --------------------------------------------- LAST ITEM --- ---t------------------------------------------------------------------------- i I i I i i I Tracking Numbers: 066443715814214, 066443715814221, 066443715814238, 066443715814245, 066443715814252, 06644; Subtotal 1,394.50 Freight 88.25 Sales Tax 0.00 Pavment/Credit Amount 0.00 R2 1,482.75 CO - ®f C -it_ °�°� n INDIA cS rme I' NA RTAIL TAX EXEMPT PAGE LL CERTIFICATE NO. I003120155 002 0 ONE CIVIC S FEDERAL EXCISE TAX EXEMPT PURCHASE ORDER NUMBER CARMEL, INDIANA 46032-2584 35-60000972 FORM APPROVED � �� BY STATE BOARD PURCHASE ORDER OF ACCOUNTS FOR CITY THIS NUMBER MUST APPEAR ON INVOICES,A/p DATE DATE RE OF CARMEL- 1997 VOUCHER iJ REQUIRED DELIVERY IIII oGU REQUISITION NO. SHIPPING LABELS AND ANY M CO RESPONDENCE. I VENDOR NO. Child Source DESCRIPTION VENDOR 7099 1Al00stcr Pike Carmol Police DGPartrnent 1l SHIP 3 Civic equ2 e vdlna, �� $�# TO 'ONFIRMATION 2 Cannel, IN , BLANKET CONTRACT ^^w PAYMENT TERMS (31 7)5r 71 ��py% QUANTITY / gyp UNIT OF MEASURE FREIGHT 'CCourlt vU,,S 2'00 DESCRIPTION Each Shlpprng UNIT PRICE EXTENSION Each Chime Key Fft 00 Alenjur•e lnianl Seal 61472.6.5��4�2.� $88.25 $139.4.5 $88.Z5 $1,394 Sub Total: --°' -50 $1,482.75 DD I Invoice To: tt CI CaNd P011ca Dopattmofit Attn: Tema Andersm -3 c(VIC Z$qumm. Calftef, IN W® ., DEPARTME PLEASE INVOICE IN DUPLICATE NT Ce®e pt• ACCOUNT PROJECT 4 PROJECT ACCOUNT PAY-f`' AMOUNT $1,Q2,75 • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE APART OF THE VOUCHER AND EVERY INVOICE AND SHIPPING INSTRUCTIONS VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED IEPAID. . • I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIAT ON SUFFICIENT TO PAY FOR THE ABOVE ORDER. ORDERED BY II�`I rQp�p�ONp � �\ZLE Ohio et Police I � ��9 �REp,SURER ��lCS pFF�CE Q� S4 ER`s Zo c�E WARRANT NO• 20---- VOUCHER NO•--.--- ALLOWED IN THE SUM OF $ I C I $ ON ACCOUNT OF APPROPRIATION FOR -------�— I e 1 - I _ l I Board Members I AMOUNT 1 hereby certify that the attached invoice(s), or PO#or INVOICE NO. ACCT#1TITLE bill(s) is (are) true and correct and that the DEPT.# materials or services itemizedr�ered and for which cha --rge is made were o iI received except_-- -- -- I ,I I 20_..__---- I -- — �� Signature li -- Title I _-- Cost distribution ledger classification if d claim paid motor vehicle highway 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)) 03/11/13 203934 car seats $1,482.75 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 Child Source IN SUM OF $ 7001 Wooster Pike Medina, OH 44256 $1,482.75 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Gift Fund PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 25670 I 203934 I -852.00 I $1,482.75 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 Tuesday, March 19, 2013 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund -------------- -------------- -------------- . chold source- , 7001 Wooster Pike, Medina OFf Invoice � 44256 I'll:33 0.723.4739 F Invoi c�Number:ax.330.721.67 99 0000203933 REMITTANC E ADDRESS: Invoice Date: 3/11/2013 WESTERN R ESERVE DISTRIBUTING, INC dba CHILD SOURCE Invoice Due Date: 4/10/2013 P.O.BOX 73714 CLEVELAND,OH 44193 Customer: CARMPD Tax ID#82-0563593 Sales Order: �-Sold°Tom 0000114972 CARMEL POLICE DEPARTMENT 3 CIVIC SQUARE CITY ` TRINITY CLINIC CARMEL, IN 46032-2584 USA 1045 OAKRIDGERD ATTN MAGGIE Carmel, IN 46032 USA FEDEX GRND iffis IC068FSM Net 30 Days ON 130 llescri6 ion , '; ARD35 INFANT CAR SEAT Q�Y Ship ed 93-211FSM VOYAGER HICHBACK 2 p W/BASEUn'tPric In.urit 93-299FSM PER PACK) 4 $ 75.0000 BACKLESS SHIELDLESS BOOSTER(4 PER PACK 4 $ $ 300.00 29.9000 $ 119.60 ---------------- 4 $ 14.9000 ---------- 59.60 LAST ITEM - ; i : : : i . _ - : IckiRg Numbers: 066443715814146, 066443715814153, 0664 37 ' 4 1 5 81 416 0 066443715814177,4 37 1 5 8 1 41 77 06644 3,7 15814184 06644: Subtotal 479.20 F 'reiar llt 79.35 Sales Tax 0.00 Pavment/Credit Amount 0.00 558.55 INDIANA RETAIL TAX EXEMPT PAGE City o Carmel CERTIFICATE NO.003120155 002 0 Jl PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT V%61 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 'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 314!2013 Child Source Carmel Police Department VENDOR SHIP 3 CIVIC squam TO 7001 Wooster Pike Carmel, IN 4602 Medina, OP 44266 (317)571-2559 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 00-590.05 4 Each On Board35 Infant Car Seat IC068FSM $75.00 $300.00 4 Each Voyager Mighback 93-211FSM $20.90 $119.60 4 Each Backless Shleidless Booster -9 $14.90 $59.60 F 9 Each shipping $79.35 $79.35 •° Il Sub Total: $558.55 Send Invoice To: Carmel Police Department Attn: Teresa Anderson 3 Civic Square Carmel, IN 46032= PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dept. ��\-- PAYMENT x•55• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION'SUFFICIENT TO PAY FOR THE ABOVE ORDER. •SHIP REPAID. •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. •PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BYl•�r SHIPPING LABELS. •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE �ihlof' p 7 Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. �,}6 CLERK-TREASURER DOCUMENT CONTROL NO. A. COPY-SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO.___.._......--...__._..WARRANT NO,....._.___...._ ALLOWED 20 IN THE SUM OF$ 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 receivedexcept.-.....--............-......---._...------.................---...._................. _ -......._..............._...................--------------------_-----------_------------------...................-.........._-....--.-..._..._.................. - 4 _ 20 .... ----- ..................... ......-........-- ...........- Signature ...............-.........----.................._-.......--------------...- ............ . ... . . .--............................................- .-. Title i Cost distribution ledger classification if claim paid motor vehicle highway fund I 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)) 03/11/13 203933 car seats $516.26 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 Child Source IN SUM OF $ 7001 Wooster Pike Medina, OH 44256 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Grant Fund PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 25661 I 203933 I -590.05 I $516.26 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 A5 WI�I j 05'6 which charge is made were ordered and JIJI (/� received except lJ` Tuesday, March 19, 2013 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund