222555 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 366725 Page 1 of 1
f ONE CIVIC SQUARE RANGE SYSTEMS
CARMEL, INDIANA 46032 5121 WINNETKA AVE N CHECK AMOUNT: $1,448.00
NEW HOPE MN 55428
CHECK NUMBER: 222555
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239010 25372 12722 1, 448 . 00 DURA BLOC
I
RANGE`
SYSTEMS Invoice
5121 Wimietka Ave N
New Hope, MN 55428
7/19/2013 12722
Carmel Police Dept. Carmel Police Department
Attn: Teresa Anderson Sgt. Ryan Jellison
3 CIVIC SQUARE 3 Civic Square
CARMEL, IN 46032 Carmel, In 46032
317-571-2599, 317-727-9862
MINOR
25372 Net 15 BB 7/19/2013 Lift Gat. . .
20 RB1000 DURA-BLOC, 24" X 12" X 9" ea 63.00 1,260.00T
NSN: 9320-01-565-6471
1 001 Shipping & Handling Charges via R&L carriers 188.00 188.00T
ETA 7/23/13
Thank you for your business.
Total $1,448.00
Phone # 763-533-9200 Fax # 763-537-6657 www.range-systems.com
C4 INDIANA RETAIL TAX EXEMPT PAGE
RY o Carmel CERTIFICATE NO.003120155 002 0 JL PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 25372
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. tVENDOR NO. DESCRIPTION
7116r20i3
Range Systamr, Carmel Police Department
VENDOR SHIP 3 CIVIC Squam
TO
M21 Nnnetka Avenue North Carmel, IN 4&W.
Now Hop@, MN W28 (317)671
CONFIRMATION B=UNIT PAYMENT TERMS FREIGHT
QUANTITY DESCRIPTION UNIT PRICE EXTENSION
Account 42-390.10
20 Each Dora-Bloc 13E1000 $183.00 $1,260.00
1 Each shipping charges $188.00 $188.00
Sub Total: � $1,448.00
Send Invoice To: 1
Cannel police Department
Attn: Teresa Anderson
3 Civic Square
Gabriel, IN 4602= PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
arrrmel Police Dept. - PAYMENT $1,446.00
.� A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN,AFFIDAVITATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE I�.AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION SUFFICI NT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED- // �
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY !jj /// (((/I
Uof SH IPPING LABELS. �a THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE C f Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
25 �)7 2 CLERK-TREASURER
)OCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
_- IN THE SUM OF$
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))
07/19/13 12722 dura blocs $1,448.00
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Range Systems
IN SUM OF $
5121 Winnetka Avenue North
New Hope, MN 55428
$1,448.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25372 I 12722 I 42-390.10 I $1,448.00 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, July 24, 2013
'/'/41
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund