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Home My WebLink About219241 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 026625 Page 1 of 1 ONE CIVIC SQUARE BOB BLOCK FITNESS EQUIP CHECK AMOUNT: $197.00 CARMEL, INDIANA 46032 8128 CASTLEWAY COURT WEST INDIANAPOLIS IN 46250 CHECK NUMBER: 219241 CHECK DATE: 4/24/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4350000 25701 83792-IN 197 . 00 TREADMILL REPAIRS INVOICE INVOICE NUMBER 0083792-IN INVOICE DATE 04/17/2013 8128 Castleway Court West SALESPERSON JOSHUA BUCY Indianapolis, IN 46250 CUSTOMER NUMBER 01-CAR04 (317)845-7700 Fax:(317)845-7704 www.bobblockjitness.com SOLD TO: CARMEL POLICE DEPARTMENT SHIP TO: CARMEL POLICE DEPARTMENT 3 CIVIC SQUARE 3 CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN 46032 CONFIRM TO: TERESA ANDERSON/BILL HAYMAKER P.O.NUMBER PAID BY: CHECK# REFERENCE TERMS DUE ON RECEIPT ITEM DESCRIPTION ORDERED SHIPPED B/O UNIT PRICE TOTAL REPLACED CENTER POD TRUE CS5.0 S/N:08-LC0476L PED 09-5T01633C /MISC PARTS CENTER POD 1 1 0 80.00 80.00 /LABOR SERVICE LABOR 80.00 /TRIP SERVICE TRIP CHARGE 25.00 THANK YOU FOR THE OPPORTUNITY TO BE OF SERVICE Net Invoice: 185.00 Freight: 12.00 Sales Tax: 0.00 197.00 Less Deposit: 0.00 197.00 C0 INDIANA RETAIL TAX EXEMPT PAGE ity o C rmel CERTIFICATE NO.003120155 002 0 Jl ��1//(SJS �✓JL PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 35-60000972 25701 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE. PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 41101 i3 Bob Block Fitness Equipment Camel Police Department VENDOR SHIP TO Civic Square 8`128 Castle way Court iVbst Catmol, IN 46M IndlanaDoll$, IN 46?_�0 (3171671 CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT QUANTIITYs� { UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 43.63it .00 9 Each repairs to treadmill $107.00 $197.00 Sub Total: $197.04 - '" �... z Ah..`" • ., . a9f Send Invoice To: ; Carmel Police Department Attn: Teresa Anderson Civic Square Carmel, IN 40032- PLEASE INVOICE IN DUPLICATE DEPARTMENT ' ACCOUNT PROJECT T PROJECT ACCOUNT AMOUNT Carmel Police Dept. PAYMENT $107.00 • A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. • C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ../- •PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY SHIPPING LABELS. •THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE C:Hi( Af PfiHOO AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 17 CLERK-TREASURER DOCUMENT CONTROL NO. A PV. COPY-SIGN AND RETURN TO CLERK'S OFFICE . _ I VOUCHER NO-------------_......_WARRANT NO..-._...---...._--.. ALLOWED 20 IN THE SUM OF$ 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 received except..-------__----- 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)) 04/17/13 83792-IN repairs to treadmill $197.00 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 VOUCHER NO. WARRANT NO. ALLOWED 20 Bob Block Fitness Equipment IN SUM OF $ 8128 Castleway Court West Indianapolis, IN 46250 $197.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 25701 I 83792-IN I 43-500.00 I $197.00 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 Monday, April 22, 2013 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund