HomeMy WebLinkAbout222225 07/18/2013 ��ewf CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1
ONE CIVIC SQUARE CHILD SOURCE CHECK AMOUNT: $1,093.60
CARMEL, INDIANA 46032 PO BOX 73714
a _o� CLEVELAND OH 44193 CHECK NUMBER: 222225
CHECK DATE: 7/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
852 5023990 25349 209840 1, 093 . 60 CAR SEATS
09 S@"�® Invoice
60
18210mium, Invoice Number: 0000209840
7001 Wooster Pike,Medina,OH 44256
Ph:330.723.4739 Fax:330.721.6799 Invoice Dale: 6/27/2013
REMITTANCE ADDRESS: Invoice Due Date: 7/27/2013
WESTERN RESERVE DISTRIBUTING, INC.
d Customer: CARMPD
ba CHILD SOURCE
P.O.BOX 73714 Sales Order: 00001 17782
CLEVELAND,OH 44193
Tax ID#82-0563593 _ ~�
Sold T Ship>To.•
CARMEL POLICE DEPARTMENT,CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 OAKRIDGE ROAD
CARMEL,IN 46032-2584 USA Carmel, IN 46032 USA
�uu::�.n�..r=F.O. :+a• �a hipVisz`.. ;;;:'...�.. .u.�........,y` ...:�'�._...I".a�a�� ,5, .f:... �S?''�:.`. ..
25349 FEDEX GRND ORIGIN Net 30 Days
_ _
._.»..�.�.__... ..,.�_ -•z ;' .nit rice°�< .�trtount
"::'' • .;. Item,.?' s:w. "e.• ;'.._Description;: ° :.. _..__ g1YSItiPped,
3702098 TITAN 5 CARSEAT 50#2PK 2 $ 57.7500 $ 115.50
IC068FSM ON BOARD35 INFANT CAR SEAT W/BASE 5 $ 77.4000 : $ 387.00
93-209FSM HIGH BACK BOOSTER FRONT ADJ 2PK 6 $ 47.2000 ! $ 283.20
22-491FSM PRONTO B/P H/B BOOSTER 30-100#CONVERTS TO 6 $ 29.9000 $ 179.40
NO BACK
— — -----. LAST ITEM ------- ---------------- ------------------------ ----------------------------
Tracking Numbers: 066443715925088, 066443715925095, 066443715925101, 066443715925118, 066443715925125, 06644:
Subtotal 965.10
Freight 128.50
Sales Tax 0.00
Payment/Credit Amount 0.00
r� . .._ 'T3;llance 1,093.60
INDIANA RETAIL TAX EXEMPT PAGE
City o C drme i CERTIFICATE NO.003120155 002 0 1i PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 253"
35-60000972
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
662612013
Child Source ent .
VENDOR SHIP
TO
7001 Wooster PII r /Camel, 1&1 r
Medina, OH 44256
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 002.00
1 Each shipping $128.50 $128.50
6 Each Pronto BIP H/B Booster' 22-491FSM $29.90 $179.40
2 Each Titan 5 Carseat 37 20 "•'. $57.75 $915.50
6 Each High Back Booster Front ADJ ''� � _9 266F $47.20 $283.20
5 Each On Board 35 Intarn Car Seat �.` g�`°� ,# 86� #q F• '-'.. $71.40 $381.00
Sub Total: $1,093.80
§:
Send Invoice To:
Carmel Police Department
Attn: Teresa Anderson
3 Civic Square
Camel, IN PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. PAYMENT $1,093.60
/J A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
• I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIPPING INSTRUCTIONS // �
' THIS APPROPRIATIO�lFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
...
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
f
SHIPPING LABELS. f
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE Ch 4z?of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. V
4-1 CLERK-TREASURER
DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT
ALLOWED 20
IN THE SUM OF$
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
20
............................................--........-- --...-..............................-...---..._._.............--...-....................---
Signature
..._.........._................ ..................................__......._......................-..........._._....................................... .....
.Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
___
ALLOWED 20 ___
--'---
---- |N SUM OF
$1,093.60
ON ACCOUNT OFAPPROPRIATION FOR
Carmel Police Gift Fund
' O#' ~er Board Members
25349 209840 -852.00 $1,093.60 | hereby certify that the attached invoima(a). or
biU(e) ia (ane) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
. VVednasday. Ju|y1U. 2013
Chief of Police
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))
06/27/13 209840 car seats $1,093.60
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