HomeMy WebLinkAbout218394 03/25/2013 =�e.F CITY OF CARMEL, INDIANA VENDOR: 026625 Page 1 of 1
ONE CIVIC SQUARE BOB BLOCK FITNESS EQUIP
CARMEL, INDIANA 46032 8128 CASTLEWAY COURT WEST CHECK AMOUNT: $814.00
'�c. 3• INDIANAPOLIS IN 46250
CHECK NUMBER: 218394
CHECK DATE: 3/2512013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350000 25650 83509-IN 814 . 00 TREADMILL REPAIRS
ff 11"Z 17f, INVOICE
witness �qui�ment INVOICE NUMBER 0083509-IN
INVOICE DATE 03/04/2013
8128 Castleway Court West SALESPERSON JOSHUA BUCY
Indianapolis,IN 46250 CUSTOMER NUMBER 01-CAR04
(317)845-7700
Fax: (317)845-7704
www bobbl ockfitness.com
SOLD TO: CARMEL POLICE DEPARTMENT SHIP TO: CARMEL POLICE DEPARTMENT
3 CIVIC SQUARE 3 CIVIC SQUARE
CARMEL, IN 46032 CARMEL, IN 46032
CONFIRivI TO: ROBERT
P.O.NUMBER PAID BY: CHECK# REFERENCE TERMS
25650 DUE ON RECEIPT
ITEM DESCRIPTION ORDERED SHIPPED B/O UNIT PRICE TOTAL
SERVICE CALL ON 3/4/13 BY BEN ASBURY
TRUE 700 SN:03-61299H -REPLACED DECK/BELT AND
BACK ROLLER
/MISC PARTS DECK 1 1 0 281.00 281.00
/MISC PARTS BELT 1 1 0 278.00 278.00
/MISC PARTS REAR ROLLER 1 1 0 150.00 150.00
/LABOR SERVICE LABOR 80.00
/TRIP SERVICE TRIP CHARGE 25.00
THANK YOU FOR THE OPPORTUNITY TO BE OF SERVICE Net Invoice: 814.00
Freight: 0.00
Sales Tax: 0.00
814.00
Less Deposit: 0.00
814.00
C14 INDIANA RETAIL TAX EXEMPT PAGE
®f; Carmel CERTIFICATE NO.003120155 002 0
\\��//// \\��1//// 1L �1.� PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 2D
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
213
Bob Block Fitnoos EquIpme nt Cwmel Police Department
VENDOR 1 TOIP 3 CIvIc Square
8128 Castlway Craurk;'west Carmol, IN 46M
t
indlanapoils, IN M2; (317)671-
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 48-606.00
1 Each repairs to treadmill $814.00 $814.00
Sub Total: $814.00
"t 1
FN
1•' \�P 'fie }� •..9•—��• ..2
a
Send Invoice To:
Carmel Police Department
Attu. Teresa Anderaon
3 Clylc Square
Carmel, IN 4 PLEASE INVOICE IN DUPLICATE
DEPARTMENT , ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. /, PAYMENT.- $814.0€1
L A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. /
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. �a
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE 4�l'�1g 9 Q Police
'
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
215 6 5 a CLERK-TREASURER
DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO, WARRANT
ALLOWED 20
IN THE SUM OF$ 1
,I
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
20
..................................................................................................................................................._.....................................
Signature
...... ......._.._................................._._.............._............_........................_._. ................._._........._.........._.
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
I
I
VOUCHER NO. WARRANT NO.
ALLOWED 20
Bob Block Fitness Equipment
IN SUM OF $
8128 Castleway Court West
Indianapolis, IN 46250
$814.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25650 I 83509-IN I 43-500.00 I $814.00 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 20, 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))
03/04/13 83509-IN repairs to treadmill $814.00
I 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