219773 05/07/2013i
CITY OF CARMEL, INDIANA VENDOR: 363047 Page 1 of 1
r ONE CIVIC SQUARE IN-RANGE SUPPLIES LLC CHECK AMOUNT: $944.50
�o CARMEL, INDIANA 46032 5121 WINNETKA AVE N
o� NEW HOPE MN 55428 CHECK NUMBER: 219773
CHECK DATE: 5/7/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
900 4359023 25715 12403 944 . 50 DURA—BLOC
RANGE Invoice
5121 Winnetka Ave N
New Hope, MN 55428
4/26/2013 12403
Carmel Police Dept. Carmel Police Department
3 CIVIC SQUARE Sgt. Ryan Jellison
CARMEL, IN 46032 3 Civic Square
Carmel, In 46032
317-571-2599, 317-727-9862
Net 30 BB 4/25/2013 Lift Gat. . .
12 RB1000 DURA-BLOC, 24" X 12" X 9" ea 63.00 756.00T
NSN: 9320-01-565-6471
1 001 Shipping & Handling Charges VIA R&L CARRIERS 188.50 188.50T
ETA 4/29
Thank you for the opportunity, Brandon Bernstein 612-747-7999.
Total $944.50
Phone # 763-533-9200 Fax # 763-537-6657 www.range-systems.com
INDIANA RETAIL TAX EXEMPT PAGE
City o Carmel . CERTIFICATE NO.003120155 002 0 11 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 °4 t�
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
d>A9.14
In Range Supplies Cannel Police Depadment
VENDOR SHIP
TO 3 Civic Squall
5121 Wintnetka Avenuo North Carmel, IN 46032
Now Hono. PAN 66428 (3171 qT4
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
I QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 00-6M.23
1 Each shipping charges $168.50 $185.50
12 Each Durz-Oloc R131000, $63.00 $756.00
Sub Total: $944.55
Send Invoice To:
Carmel Polico DepaA lent
Attn:Teresa Andemon
3 Civic squaro
Carmel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cafinei Police Dept. -��? PAYMENT W4•50
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
I NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY�THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRSUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID. �
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. (/
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE t !i° lat At palipm
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
L'.-7
Z o C CLERK-TREASURER
DOCUMENT CONTROL NO. A;.�. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.............__.._-.
ALLOWED 20
_ IN THE SUM OF$
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
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))
04/26/13 12403 dura blocs $944.50
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
In Range Supplies
IN SUM OF $
5121 Winnetka Avenue North
New Hope, MN 55428
$944.50
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Grant Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25715 12403 -590.23 $944.50
I hereby certify that the attached invoice(s), or
I I _
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
Tuesday, April 30, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund