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Home My WebLink About223550 08/27/2013 CITY OF CARMEL, INDIANA VENDOR: 178620 Page 1 of 1 ONE CIVIC SQUARE KUSTOM SIGNALS,INC CARMEL, INDIANA 46032 PO BOX 411882 CHECK AMOUNT: $133.00 ? ATTN:ACCTS REC „o„= CHECK NUMBER: 223550 KANSAS CITY MO 64141-1882 CHECK DATE: 8/27/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 4350000 25397 486123 133 . 00 RADAR REPAIR Invoice Number 486123 1(UST®M SIGNALS INC. 1111111111111111111 Invoice Date 08/21/13 A PUBLIC SAFETY EQUIPMENT COMPANY REM_IT•TQ_ Customer Number 16673 1010 W. Chestnut/P.O. Box 947 KUSTOM.SIGNALS -INC. Chanute, KS 66720-0947 FO4t1:882:; h._ _ Order Number 191231 SR (620)431-2700 Fax(620)431-2734 KANSASCITY; MO:_:64`1.4]-1882. Customer PO 25397 Page 1 of 1 SOLD TO SHIP TO CARMEL POLICE DEPT CARMEL POLICE DEPT POLICE DEPT HDOTRS POLICE DEPT HDQTRS 3 CIVIC SQUARE 31 FIRST AVE NW CARMEL IN 46032 CARMEL IN 46032 Net Due Date 09/20/13 Terms net 30 Shipping UPS Quantit :..• .;: ;_. ._ �aa, =k,. - a .,;, y �.,;= - 4 ;: ... Part Number , ria DESCRIPTION:.:^Se`rial #a ,� ` Extended ;. °�� y � . ,a Prices �s 3 �,. 1 200-2072-OOR PRO-LITE REPAIR LP02221 OW PROLITE RECERTIFY BRIAN SMITH 317-571-2594 """""NO ESTIMATE REQUIRED 1 TRACKING DATE SUMMARY FOR THIS REPAIR DATE RECEIVED 8-01-13 POHOLD 8-01-13 Technician Start/End Date:8/2/2013 Technician Start/End Date:8/2/13 Technician Start/End Date:8/2/2013 PO Received: 8/20/13 1 888-8888-33 CS FREIGHT GROUND 18.00 18.00 OUTBOUND SHIPPING 10 111-1111-11 OOW Laser Labor tenths of hr OOW Laser Labor tenths of hr Pro-Lite Laser Serial#LP02221 Assessment Finding: Customer has specified(RECERTIFICATION ONLY) Regression test found NO minor or major operating inadequacy Recertified 7mm TOTAL Pulse Width Calibration 17.41 131.8 32.55 19.999692 1 222-2320-00 RECERTIFICATION, PRO-LITE+ 115.00 115.00 1 222-2312-01 CS ROAD TEST ASSESSMENT 5 111-1111-11 OOW Laser Labor tenths of hr OOW Laser Labor tenths of hr Road Test Labor REMIT TO: FEDERAL ID # 43-1757730 Subtotal 133.00 KUSTOM SIGNALS, INC. o PO BOX 411882 III IIIIIIIIIIIVIII I VIII /o Tax 0.00 KANSAS CITY, MO 64141-1882 WWW.KUSTOMSIGNALS.COM TOTAL 133.00 INDIANA RETAIL TAX EXEMPT PAGE City o Carmel CERTIFICATE NO.003120155 002 0 1i PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 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 3t15M3 :I Kustom Signals Cannel Police Department VENDOR SHIP 3 CIVIC SgUarf@ TO P.O. Box 41 IW2 Carmel, IN dl Kansas City, MO 14149-111 (317)571-25% CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 4M00.00 9 Each repair to radar $133.00 $133.00 Sub Total: $133.00 Ike f� -4 - • `�4 V Send Invoice To: I Carmel Police Department Attn: Tetnea Anderson 3 Civic Squam Carmel, IN 32a PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police 13eE2f. PAYMENT $133.00 • 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 THAT7HERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATIONS'FFICIENT TO PAY FOR THE ABOVE ORDER. •SHIP REPAID. •C.O.D.SHIPMENTS CANNOT BE ACCEPTED. • ORDERED BY PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ghlof•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE of Police AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. 2 3 J 7 CLERK-TREASURER DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE J VOUCHER NO.---...- NO....-- ALLOWED 20 _ IN THE SUM OF $ ON ACCOUNT OF APPROPRIATION FOR Board Members PEP #or ,DEPT. INVOICE NO. ACCT#/TITLE AMOUNT 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)) 08/21/13 486123 radar repairs $133.00 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 Kustom Signals IN SUM OF $ P.O. Box 411882 Kansas City, MO 64141-1882 $133.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 25397 I 486123 I 43-500.00 I $133.00 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, August 26, 2013 (Z Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund