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Home My WebLink About219111 04/10/2013 CITY OF CARMEL, INDIANA VENDOR: 367017 Page 1 of 1 ONE CIVIC SQUARE T S I,INC ` CARMEL, INDIANA 46032 500 CARDIGAN ROAD CHECK AMOUNT: $676.13 SHOREVIEW MN 55126 CHECK NUMBER: 219111 CHECK DATE: 4/10/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4350000 25669 90556072 676 . 13 CALIBRATE FIT TEST IN 500 Cardigan Road Tel: (651)483-0900 Page 1 of 1 Shoreview, MN 55126 Fax:(651)481-1220 USA Web:www.TSI.com EIN 41-0843524 Email:answers @TSI.com ® DUNS 00-625-3124 QQ Manufacturer of TSIO, AlnorO and Airflow branded VO I�+�G Remit-To If payment.by Wire: Remit-To US Bank National Association TSI Incorporated 225 S. Sixth Street SDS 12-0764 P.O. BOX 86 Minneapolis, MN 55402 MINNEAPOLIS, MN 55486-0764 A.B.A. No. 091000022 Bill-To-Party SWIFT No. USBKUS441MT Account No. 1-502-5005-9915 CARMEL POLICE DEPT 3 CIVIC SO Invoice Number 90556072 CARMEL, IN 46032 Invoice Date 03/2612013 USA Reference Order 430622/03/21/2013 Delivery Note No./Date /03/26/2013 PO No. 25669 Customer No. 5112824 Currency USD Term of Payment Net 30 days Incoterm 2010 CPT: Prepay&Add CONSIGNEES PREMISES Ship Via UPS GROUND Bill of Lading 1Z7W697A0355058627 Item Material/Description Quantity Unit Price Value 1 CL-8030 1 EA 665.00 665.00 Clean and Calibrate Model 8030 Delivery Num:80492879 SN: (8030091708) Net Total 665.00 Freight 11.13 Invoice Amount 676.13 WE HEREBY CERTIFY THAT THESE GOODS WERE PRODUCED IN COMPLIANCE WITH ALL APPLICABLE REQUIREMENTS OF THE FAIR LABOR STANDARDS ACT,AS AMENDED AND APPLICABLE RULES,REGULATIONS AND ORDERS OF THE UNITED STATES DEPARTMENT OF LABOR OR OTHER ADMINISTRATIVE AGENCIES ISSUED PURSUANT THERETO.TSI Terms and Conditions apply and are incorporated by reference. See http:tlwww.tsi.com/tc.pdf ii_ INDIANA RETAIL TAX EXEMPT PAGE ity ® CERTIFICATE N0.003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT ISM 35-60000972 ONE'CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE. 'PURCr11)S_qE-QRDFR2TE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 3AIMS r Il CafffloI Police Wpartl ont VENDOR SHIP 3 Civic Square CaMigran Road TO Camol, IN 40032 Showlew, LiiIN 651 26 571-2559 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT Account ��UUN T70F MEASURE DESCRIPTION UNIT PRICE EXTENSION `A' ccount 33ed"'GF64i1c00 t Each calibrate fit test instrument Model 8030-PorlaCount Pro $885.00 $085.00 Sub Total: $885.00 t , Send Invoice To: Carmel Pella, Department Attn: Teresa Anderson 3 Civic Square Carmel, IN 46032- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dept• ; �� PAYMENT $665•00 �,. A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION SUF F1CIENT TO PAY FOR THE ABOVE ORDER. •SHIP REPAID. •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY •PURCHASE ORDER NUMBER MUST APPEAR ON ALL /. / d SHIPPING LABELS. f of g Police•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE i6"� AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. f 5 6� CLERK-TREASURER DOCUMENT CONTROL NO. A.P . COPY-SIGN AND RETURN TO CLERK'S OFFICE fti VOUCHER NO.'S-.-.---._-_-_._WARRANT NO,...--_.-.-..._-----. ALLOWED 20 _ l r IN THE SUM OF$ � 4 ON ACCOUNT OF APPROPRIATION FOR P 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 f 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 TSI IN SUM OF $ 500 Cardigan Road Shoreview, MN 55126 $676.13 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 25669 , 90556072 I 43-500.00 I $676.13 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 Monday, April 08, 2013 77 La:t=l�;�—) 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)) 03/26/13 90556072 clean/calibrate fit test instrument $676.13 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