219725 05/07/2013 CITY OF CARMEL, INDIANA VENDOR: 362355 Page 1 of 1
ONE CIVIC SQUARE G H S
s o CARMEL, INDIANA 46032 8349 N WASHINGTON STREET CHECK AMOUNT: $8,051.00
®O`? SHERIDAN IN 46069 CHECK NUMBER: 219725
CHECK DATE: 5/7/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350100 25703 2013-1529 1, 295 . 00 EMERGENCY EXIT FIXTUR
1205 4350100 2013-1530 6, 756 . 00 BUILDING REPAIRS & MA
GHs, Inc. 12� S
Service
Women-Owned Business Enterprise Guaranteed
8349 North Washington Street Hnnesl
Sheridan, IN 46069
INC
Bill To Invoice
City of Carmel
Jeff Barnes Date Invoice#
One Civic Square
Carmel,IN 46032 4/26/2013 2013-1530
P.O. No. Due Date Terms
Jell'B. 5/26/2013 Net 30
Quantity Descri tion Price Each Amount
Materials-Cliange 12 250w MH pole lights to I-ILRE-D65-Y 5,856.00 5,856.00
65w LED lights with surge suppression
Labor - Change 12 250w MI-1 pole lights to 65w LED lights 900.00 900.00
USA Lighting Warranty 10 years
D
MAY 0 6 2013 i
By
Thank you for your business. Total $6,756.00
Payments/Credits $0.00
A 1.5%Service Charge will be assessed on amounts over 30 days past due. Balance Due
$6,756.00
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))
04/26/13 2013-1530 $6,756.00
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
GHS, Inc.
IN SUM OF $
8349 North Washington Street
Sheridan, IN 46069
$6,756.00
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
1205 I 2013-1530 I 43-501.00 I $6,756.00 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, May 06, 2013
A
Director, Admi stration
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
GHS, Inc. Guarante-,A
Women-Owned Business Enterprise
8349 North Washington Streetn at
Sheridan, IN 46069 Scrv;cc
ING•
Bill To Invoice
City of Carmel Police Department
Attn: Teresa Anderson Date Invoice#
3 Civic Square
Carmel,IN 46032 4/26/2013 2013-1529
P.O. No. Due Date Terms
5/26/2013 Net 30
Quantity Des ri ion Price Each Amount
20 LED Emergency Exit fixtures-white case with red-5 year 1,500.00 1,500.00
warranty- double-sided or single sided- installed.
I LED emergency exit fixture-not installed-on site with City of 35.00 35.00
Carmel Police Dept
REBATE From Duke Energy
20 x$12.00 $240.00
Total cost of project after rebate $ 1,295.00
Rebate is to replace 20 incandescent exit signs with LED
PLEASE WRITE CHECK TO GHS,INC.
IN THE AMOUNT OF $ 1,295.00
Rebate from Duke Energy to GHS,Inc. 240.00 -240.00 -240.00
TOTAL $ 1,535.00
We appreciate your business
Total $1,295.00
Payments/Credits $0.00
A 1.5%Service Charge will be assessed on amounts over 30 days past due. Balance Due $1,295.00
Cit� - of- Carmel INDIANA RETAIL TAX EXEMPT PAGE
CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 25703
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A1P
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
4/1012093
CHS, Inc. Carmel Police Department
VENDOR SHIP 3 Civic Square
TO
IW North Washington Street Carmel, IN 46032
hoddan, IN 4 (3171571
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
` QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43-601.00
1 Each LED Emergency Exit fixtures $1,425.00 $1,425.00
Sub Total; $1,425.00
g .} dal •
tu
.....
Ae
VI
Send Invoice To:
Carrnal Police Department
Attn:Teresa Anderson
3 Civic Square
Camel, IN 45032@ PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. �s' PAYMENT $1,425.00
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY •..-� / ��
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE e-hia t eitf Pi►liio a
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
DOCUMENT CONTROL NO. 2 15' 10 ATI COPY-SIGN AND RETURN TO CLERK'S OFFICE
I
VOUCHER NO. WARRANT
-
ALLOWED 20
IN THE SUM OF$
S
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))
04/26/13 2013-1529 LED emergency exit fixtures $1,295.00
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
GHS, Inc.
IN SUM OF $
8349 North Washington Street
Sheridan, IN 46069
$1,295.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2570_3_ 2013-1529 I 43-501.00 I $1,295.00 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, May 01,2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund