224445 09/25/2013 CITY OF CARMEL, INDIANA VENDOR: 362650 Page 1 of 1
0 zi• ONE CIVIC SQUARE CENTER FOR PUBLIC SAFETY EXCELLMCK AMOUNT: $859.80
CARMEL, INDIANA 46032 4501 SINGER COURT#180
v«o� CHANTILLY VA 20151 CHECK NUMBER: 224445
CHECK DATE: 9/25/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4350900 859 . 80 OTHER CONT SERVICES
LSH IPPING &HANDLING RATES
Merchandise Total Standard (Ground) 2-3 Day (Air Next Day Air
Service Service) US Only
Up to$10.00 $5.95 $13.95
$10.01 -$20.00 $6.95 $14.95
$20.01 -$30.00 $8.95 $16.95
$30.01 -$50.00 $10.95 $18.95
$50.01 -$70.00 $14.95 $22.95
$70.01 -$100.00 $16.95 $24.95
Call CPSE for rate
$100.01 -$150.00 $19.95 $27.95
$150.01 -$200.00 $24.95 $32.95
$200.01 -$400.00 $29.95
$400.01 -$600.00 $36.95 Call CPSE for rate
$600.01 -$800.00 $40.95
$800.01 + Call CPSE for rate
The above rates apply for Continental U.S. only. Please call CPSE for International rates.
1
Merchandise Total $760 . 00
VA residents add 5% sales tax
CA residents add 7.25% sales tax
Shipping&Handling(UPS Ground unless otherwise specified) 99. 80
TOTAL ENCLOSED $859 . 80
PAYMENT INFORMATION
[]Check (enclosed) ❑Cash
[]Visa 1:1 MasterCard ❑AMEX El Discover
Name on card:
Credit Card# Exp.Date:
Signature:
Billing Address
CUSTOMER SHIPPING INFORMATION (no PO Box)
Name: Denise Snyder Title: Budget & Accreditation Mg
Organization: Carmel Fire Department
Address: 2 Civic Square
City: Carmel State: IN Zip: 46032
Phone: 317-571-2600 Fax:
Email: dsnyder @carmel . in.gov
4 Small Accreditation Plaques @ $190 . 00 each + $24 . 95 S&H per plaque
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))
$859.80
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
Center for Public Safety Excellence
IN SUM OF $
4501 Singer Court, #180
Chantilly, VA 20151
$859.80
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
1120 I I 43-509.00 I $859.80 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
P 2 3 2013
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund