220365 05/21/2013 CITY OF CARMEL, INDIANA VENDOR: 361937 Page 1 of 1
i ONE CIVIC SQUARE T B A NORTH CHECK AMOUNT: $2,490.35
CARMEL, INDIANA 46032 309 GRADLE DRIVE
o� CARMEL IN 46032 CHECK NUMBER: 220365
CHECK DATE: 5/21/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4231500 3LH4840 1, 479 . 78 OIL
1110 4237000 3LH7035 223 . 35 REPAIR PARTS
1110 4237000 3LH7855 r -46 . 59 REPAIR PARTS
1110 4237000 3LI0009 !255 .44 REPAIR PARTS
1110 4237000 3LI3711 ,146 . 67 REPAIR PARTS
1110 4237000 3LI7161 1265 . 60 REPAIR PARTS
1110 4237000 3LI8344 ✓ 166 . 10 REPAIR PARTS
TBA North Invoice
309 Gracile Dr. No. 03LI8344
Carmel, IN 46032
317-574-1957 FAX: 317-574-1982 II�III`I "I I " 1i1� {I I) III II�II
I I I I I I I Page 1
13:49:36 May 15 2013
CUSTOMER NUMBER Invoice NUMBER Invoice DATE PACKING SLIP TERMS WHSE
318 03 L- 18344 05/15/13 03SY9035001 NET 10TH 030
BILL TO: SHIPPED TO:
CARMEL POLICE CITY GARAGE CARMEL POLICE CITY GARAGE
3 CIVIC SQUARE 3400 W 131ST
CARMEL, IN 46032 CARMEL, IN 46074
Dept: 002 CARMEL POLICE CITY GARAGE Contact: JASON /Route: NORTH Direction:
YOUR P.O.NUMBER ORDER DATE - CSR SHIPPED VIA CARTONS OPER
05/15/13, 13:42:12 000001 ONLINE ORDERS N NORTH A ACX
*** ACX Reference No: AM4923 ***
ITEM DESCRIPTION UNIT ORDER BACK INV LIST CORE NET NET EXT
BIN QTY ORDERED QTY PRICE PRICE PRICE CORE PRICE
RAF ATD1159P AT POLICE PAD SET U EA 2 0 2 94.88 0.00 42.07 0.00 84.14
RAF ATD698P AT POLICE PAD SET U EA 2 0 2 92.41 0.00 40.98 0.00 81.96
TOTAL PURCHASE TOTAL LIST TOTAL MDSE TOTAL CORE FREIGHT TAX PCT TAX AMT INVOICE TOTAL PAYMENTS BALANCE DUE
166.10 374.58 166.10 0.00 0.00 0.00 166.10 0.00 166.10
2.08% service charge on past due accounts(25% per annum).
Core returns must be in original box. All new returns must
be resalable. No return after 30 days without invoice.
-----------------------------------------------------=
TBA North Invoice
309 Gracile Dr. No. 03LI7161
Carmel, IN 46032
317-574-1957 FAX: 317-574-1982 II II II I( I I VIII I( I II II I I II
Page 1
09:20:44 May 14 2013
CUSTOMER NUMBER Invoice NUMBER Invoice DATE PACKING SLIP TERMS WHSE
318 03LI7161 05/14/13 03SY7619 001 NET 10TH 030
BILL TO: SHIPPED TO:
CARMEL POLICE CITY GARAGE CARMEL POLICE CITY GARAGE
3 CIVIC SQUARE 3400 W 1311
31ST
CARMEL, IN 46032 CARMEL, IN 46074
Dept: 002 CARMEL POLICE CITY GARAGE Contact: , JASON/317-733-4600 Route: NORTH Direction:
YOUR P.O.NUMBER ORDER DATE CSR SHIPPED VIA ' CARTONS OPER
05/14/13, 09:19:42 400003 JIM RATLIFF N NORTH A 403
ITEM DESCRIPTION BIN UNIT ORDER BACK INV LIST CORE NET NET EXT
QTY ORDERED QTY PRICE PRICE PRICE CORE PRICE
SKF BR930548K SKF BRANDED HUB UNITS U EA 0 0 2 263.38 0.00 132.80 0.00 265.60
TX: 010 1
TX: 040 1
TOTAL PURCHASE TOTAL LIST TOTAL MDSE TOTAL CORE FREIGHT TAX PCT TAX AMT INVOICE TOTAL PAYMENTS BALANCE DUE
265.60 526.76 265.60 0.00 0.00 0.00 265.60 0.00 265.60
2.08% service charge on past due accounts(25% per annum).
Core returns must be in original box. All new returns must
be resalable. No return after 30 days without invoice.
— -------------------------------------=------------
TBA North Invoice
309 Gradle Dr. No. 03LI0009
Carmel, IN 46032
317-574-1957 FAX: 317-574-1982 II II�I (I VIII ( I I I I II II I I II
Page 1
08:50:41 May 02 2013
CUSTOMER NUMBER Invoice NUMBER Invoice DATE PACKING SLIP TERMS WHSE
318 03LI0009 05/02/13 03SX9244001 NET 10TH 030
BILL TO: SHIPPED TO:
CARMEL POLICE CITY GARAGE CARMEL POLICE CITY GARAGE
3 CIVIC SQUARE 3400 W 131ST_
CARMEL, IN 46032. CARMEL;IN 46074
Dept: 002 CARMEL POLICE CITY.GARAGE Contact: /317-733-4600 Route:NORTH Direction:
YOUR P.O.NUMBER ORDER DATE CSR SHIPPED VIA CARTONS OPER
39689 05/02/13, 08:32.29 400009 CRAIG MILLER N NORTH A 409
ITEM DESCRIPTION BIN UNIT ORDER BACK INV LIST CORE NET NET EXT
QTY ORDERED CITY PRICE PRICE PRICE CORE PRICE
****BUYOUT ORDER, do not
pick. Part is not
returnable after 15 days
from purchase****
ACD 15-80640 89018695 MOTOR KIT ENG CO U EA 1 0 1 155.55 0.00 89.95 0.00 89.95
DOR 620-974 DUAL FAN ASSEMBLY NONE EA 1 0 1 315.78 0.00 165.49 0.00 165.49
TOTAL PURCHASE TOTAL LIST TOTAL MDSE TOTAL CORE FREIGHT TAX PCT TAX AMT INVOICE TOTAL PAYMENTS BALANCE DUE
255.44 471.33 255.44 0.00 0.00 0.00 255.44 0.00 255.44
2.08% service charge on past due accounts(25% per annum).
Core returns must be in original box. All new returns must
be resalable. No return after 30 days without invoice.
---------------------------------------------------------
TBA North Invoice
309 Gradle Dr. No. 031-1-14840
Carmel, IN 46032
317-574-1957 FAX: 317-574-1982 II II II II IIII II II II II III I II
Page 1
10:18:35 Apr 24 2013
CUSTOMER NUMBER Invoice NUMBER Invoice DATE PACKING SLIP TERMS WHSE
318 03LH, 04/24/13 03SX3447001 NET 10TH 030
BILL TO: SHIPPED TO:
CARMEL POLICE CITY GARAGE CARMEL POLICE CITY GARAGE
3 CIVIC SQUARE 3400 W 131ST
CARMEL, IN 46032 CARMEL, IN 46074
Dept: 002 CARMEL POLICE CITY GARAGE Contact: /317-733-4600 Route: NORTH Direction:
E!ff�j DATE CSR SHIPPED VIA CARTONS OPER
010:17:27 400005 TOM SMITH N NORTH A 405
ITEM DESCRIPTION BIN UNIT ORDER BACK INV LIST CORE NET NET EXT
QTY ORDERED QTY PRICE PRICE PRICE CORE PRICE
OIL DIST WILL DEL MONDAY
ODC 5W30DEXOS55GAL 5W30 DEXOS FULL NONE EA 2 0 2 1352.57 0.00 739.89 0.00 1479.78
TOTAL PURCHASE TOTAL LIST TOTAL MDSE TOTAL CORE FREIGHT TAX PCT TAX AMT INVOICE TOTAL PAYMENTS BALANCE DUE
1479.78 2705.14 1479.78 0.00 0.00. 0.00 1479.78 0.00 1479.78
2.08% service charge on past due accounts(25% per annum).
Core returns must be in original box. All new returns must
be resalable. No return after 30 days without invoice. -
---------------------------------------------------------- -
11'
TBA North
Invoice
309 Gradle Dr. No. 031-1-17035
Carmel, IN 46032
317-574-1957 FAX: 317-574-1982 II IIII II IIII IIII II II III VIII
Page 1
08:16:15 Apr 29 2013
CUSTOMER NUMBER Invoice NUMBER Invoice DATE PACKING SLIP TERMS WHSE
318 03LH7035 04/29/13 03SX5990001 NET 10TH 030
BILL TO: SHIPPED TO:
CARMEL POLICE CITY GARAGE CARMEL POLICE CITY GARAGE
3 CIVIC SQUARE 3400 W 131ST
CARMEL, IN 46032 CARMEL, IN 46074
Dept: 002 CARMEL POLICE CITY GARAGE Contact: /317-733-4600 Route: NORTH Direction:
YOUR P.O.NUMBER ORDER DATE CSR SHIPPED VIA CARTONS OPER
04/29/13, 08:15:57 400003 JIM RATLIFF N NORTH A 403
ITEM DESCRIPTION BIN UNIT ORDER BACK INV LIST CORE NET NET EXT
QTY ORDERED QTY PRICE PRICE PRICE CORE PRICE
RAF ATD1159P AT POLICE PAD SET U EA 3 0 3 94.88 0.00 42.07 0.00 126.21
ACD 18A2322 19169879 KEEP 4 CARMEL U EA 0 0 2 98.90 0.00 48.57 ' 0.00 97.14
TX: 010 2
TOTAL PURCHASE TOTAL LIST TOTAL MDSE TOTAL CORE FREIGHT TAX PCT TAX AMT INVOICE TOTAL PAYMENTS BALANCE DUE
223.35 482.44 223.35 0.00 0.00 0.00 223.35 0.00 223.35
2.08% service charge on past due accounts(25% per annum).
Core returns must be in original box. All new returns must
be resalable. No return after 30 days without invoice.
----------------------------------------------------------
TBA North Credit Memo
309 Gracile Dr. No. 03LH7855
Carmel, IN 46032
317-574-1957 FAX: 317-574-1982 II IIII II IIII II IIIIII II III I II
i Page 1
16:50:26 Apr 29 2013
CUSTOMER NUMBER Credit Memo NUMBER Credit Memo DATE PACKING SLIP TERMS WHSE
318 03LH7855 04/29/13 03SX6905001 NET 10TH 030
BILL TO: SHIPPED TO:
CARMEL POLICE CITY GARAGE CARMEL POLICE CITY GARAGE
3 CIVIC SQUARE 3400 W 131ST
CARMEL, IN 46032 CARMEL, IN 46074
obrien
Dept: 002 CARMEL POLICE CITY GARAGE Contact: BILL/317-733-4600 Route: NORTH Direction:
YOUR P.O.NUMBER ORDER DATE CSR SHIPPED VIA CARTONS OPER
RGA#66474 04/29/13, 200098 BRAD BOELKE N NORTH A 298
ITEM DESCRIPTION UNIT ORDER BACK INV LIST CORE NET NET EXT
QTY ORDERED QTY PRICE PRICE PRICE CORE PRICE
MOP 5175960AB «FUEL MODULE ACCESS COVER EA -1 0 -1 8.35 0.00 -6.59 0.00 -6.59
**New Return**
Original PO 03MS0399
Original Inv#03LH2583
MOP RL134554AF FUEL PUMP/LEVEL UNIT MODU EA -1 0 -1 272.00 -40.00 N/C 0.00 . -40.00
**Core Return**
Original PO 03MS0398
Original Inv#03LH2580
TOTAL PURCHASE TOTAL LIST TOTAL MDSE TOTAL CORE FREIGHT TAX PCT TAX AMT INVOICE TOTAL PAYMENTS BALANCE DUE
-46.59 280.35 -6.59 -40.00 0.00 0.00 -46.59 0.00 -46.59
2.08% service charge on past due accounts(25% per annum).
Core returns must be in original box. All new returns must
be resalable. No return after 30 days without invoice.
I
— --------------------------------=------------
TBA North Invoice
309 Gradle Dr. No. 03LI3711
Carmel, IN 46032
317-574-1957 FAX: 317-574-1982 I) II II IIIIII II III I II III I II
Page 1
10:14:05 May 08 2013
CUSTOMER NUMBER Invoice NUMBER Invoice DATE PACKING SLIP TERMS WHSE
318 03LI3711 05/08/13 03SY3602001 NET 10TH 030
BILL TO: SHIPPED TO:
CARMEL POLICE CITY GARAGE CARMEL POLICE CITY GARAGE
3 CIVIC SQUARE 3400 W 131ST
CARMEL, IN 46032 CARMEL, IN 46074
Dept: 002 CARMEL POLICE CITY GARAGE Contact: /Route: NORTH Direction:
YOUR P.O.NUMBER ORDER DATE CSR SHIPPED VIA CARTONS OPER
05/08/13, 10:10:44 000001 ONLINE ORDERS N NORTH A ACX
*** ACX Reference No: AM3965 ***
ITEM DESCRIPTION BIN UNIT ORDER BACK ' INV LIST CORE NET NET EXT
QTY ORDERED CITY PRICE PRICE PRICE CORE PRICE
2.012 CHEVROLET CAPRICE
V8-364ci 6.OL F/I Vin 2
ID#41004
ACD 17DI404CH PAD SET,FRT DISC BRK U EA 0 0 j 94.60 .0.00 59.23 0.00 59.23
TX: 010 1 T
RAS SB580676 DISC BRAKE ROTOR U EA 0 0 2 91.38 0.00 43.72 0.00 87.44
TX: 010 2
TOTAL PURCHASE. TOTAL LIST TOTAL MDSE TOTAL CORE FREIGHT TAX PCT TAX AMT INVOICE TOTAL PAYMENTS BALANCE DUE
146.67 277.36 146.67 0.00 0.00 0.00 146.67 0.00 146.67
2.08% service charge on past due accounts(25% per annum).
Core returns must be in original box. All new returns must
be resalable. No return after 30 days without invoice.
*** Page 1. Continued on Next Page ***
City ®� Carmel INDIANA RETAIL TA1 EXEMPT PAGE
CERTIFICATE NO.003120155 002 0
PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 949
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
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
511 MM
TBA North Carmel Police Department
VENDOR SHIP
To Civiequare
3N Gradla Drive Carmel, IN 46M
Cafmol IN 46032 (M71671,
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-315.00
2 Each 55 gallon drum $739.89 $1,479.78
Sub Total: $1,479.78
C9
Send Invoice To: �- „----
Carmel Polleo Department
Attn: Temea Anderson
3 Civic Square
Carmel, IN 46M. PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
armei Police Dept. PAYMENT $1,479,79
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
• y
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THATTHERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPR TION SUFFICIENT 10'PAY FOR THE ABOVE ORDER.
• / SJ`
-.C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY ✓ '//
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE Pfil lee
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
a,j 7LERK-TREASURER
IOCUMENT CONTROL NO. A.P.I.A•r . COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
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
I
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))
04/24/13 3LH4840 2 55 gallon drums of oil $1,479.78
04/29/13 3LH7855 credit ($46.59)
04/29/13 3LH7035 repair parts $223.35
05/02/13 3LI0009 repair parts $255.44
05/08/13 3LI3711 repair parts $146.67
05/14/13 3LI7161 repair parts $265.60
05/15/13 3L18344 repair parts $166.10
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
TBA North
IN SUM OF $
309 Gradle Drive
Carmel, IN 46032
$2,490.35
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Il v I hereby certify that the attached invoice(s), or
3LH4840 42-315.00 $1,479.78_
bill(s) is (are) true and correct and that the
1110 3LH7855 42-370.00 ($46.59)
materials or services itemized thereon for
1110 3LH7035 42-370.00 $223.35 which charge is made were ordered and
1110 3LI0009 42-370.00 $255.44 received except
1110 3LI3711 42-370.00 $146.67
1110 3LI7161 42-370.00 $265.60
1110 3LI8344 42-370.00 $166.10
Friday, May 17, 2013
2t,�� �
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund