219500 04/24/2013 CITY OF CARMEL, INDIANA VENDOR: 00353224 Page 1 of 1
ONE CIVIC SQUARE SUPERIOR CARPET INSTALLERS INC
t' CHECK AMOUNT: $1,880.00
CARMEL, INDIANA 46032 1027 E GEORGIA ST
INDIANAPOLIS IN 46202 CHECK NUMBER: 219500
CHECK DATE: 4/24/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350100 25655 1303338 1, 880 . 00 CARPET REPLACEMENT
Superior Carpet Installers, Inc. Invoice
An Employee Owned Company
1027 E. Georgia Street Invoice#
Indianapolis, IN 46202
1303338
Date
Bill To: 3/31/2013
Carmel Police Dept.
Admin. Division
3 Civic Square
Carmel, IN 46032
- ----
—P:O—Number -- Project - - - Terms --- - Rep- - -- - - -.
25655 Stairs Net 20 Days RS
Quantity Description Price Each Amount
Furnish& Install New Carpet
Materials 865.20 865.20
Freight 54.80 54.80
Labor 960.00 960.00
For Billing Inquiries: Customer Total Balance Sales Tax (7.0%) $0.00
Phone: (317) 632-7441
Fax: (317) 632-7456 $1,880.00 Total $1,880.00
INDIANA RETAIL TAX EXEMPT PAGE
City o 11 Carmel CERTIFICATE NO.003120155 002 0�l PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 256%
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
201 20`13
Superior Carpet Installers, Inc. Carmel Police Department
VENDOR SHIP 1 CIVIC Square
TO
1027 E. Georgia Street Camel, IN 46032
Indlanapolig, IN 40202 (317)571
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account -MI.00
1 Each carpet replacement $1,880.00 $1,880.00
- Sub Total: $1,880.00
-
Send Invoice To:
rt
Camel Police Department
Attn: Teresa Andemon
3 Civic Square
Camel, IN 2- PLEASE INVOICE IN DUPLICATE
DEPARTMENT t! ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. r �. PAYMENT si'M.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 1 HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICIENT FOR THE ABOVE ORDER.
•SHIP REPAID. /`,r'/ J
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. /
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY //{/
ffalef SHIPPIN G LABELS. ��q f IBIIr�
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE V
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
�) CLERK-TREASURER
DOCUMENT CONTROL NO. 06A4 • COPY-SIGN AND RETURN TO CLERK'S OFFICE
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))
03/31/13 1303338 carpet replacement $1,880.00
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
Superior Carpet Installers, Inc.
IN SUM OF $
1027 E. Georgia Street
Indianapolis, IN 46202
$1,880.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
25655 I 1303338 I 43-501.00 I $1,880.00 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
Thursday, April 18, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund