HomeMy WebLinkAbout219241 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
-
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Ah..`" • ., .
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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