225759 11/05/2013 CITY OF CARMEL, INDIANA VENDOR: 00352583 Page 1 of 1
0 ONE CIVIC SQUARE BROWNELLS INC CHECK AMOUNT: $384.05
CARMEL, INDIANA 46032 200 S FRONT STREET
MONTEZUMAIA 50171-1000
CHECK NUMBER: 225759
CHECK DATE: 11/512013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4239010 25448 9435955 384 . 05 SNAP RING SLING HOOP
I
INVOICE #: 09435955 . 00 c )
10/23/2013 13 :57:38 B ROWNE L L S , INC . (46032-CITY) 955.00
10/23/2013 14:05:15
200 SOUTH FRONT STREET mandir-R
DATE SHIPPED: 10/23/2013 MONTEZUMA, IOWA 50171-1000 DLR GVN IAR
ACCOUNT #: 00296101 800-741-0015 GOVF
24 HR. FAX # (641) 623-3896 U4 P4
SOLD TO:
CITY OF CARMEL POLICE DEPT. Federal I.D. #42 0838235
ATTN: TERESA ANDERSON * * * I N V O I C E
3 CIVIC SQUARE
CARMEL IN 46032
SHIP VIA: UPS - GROUND
PAYMENT METHOD: OPEN ACCOUNT
SHIP TO:
CARMEL POLICE DEPT. TERMS: NET 30
ATTN: SGT JELLISON
3 CIVIC SQUARE
CARMEL IN 46032 FINAL
FAX #: 317-571-2507 PO NUMBER: 25448 I NVO I C E
------------------ PICKER: 671 ------------------------------------- PRICER: 914 ----------------------------------
STOCK PRODUCT QTY QTY B/0, RETAIL UNIT TOTAL
NUMBER LOCATION NAME AND DESCRIPTION ORDERED SHIPPED N OR C PRICE PRICE PRICE
160-302-011AK J02G04G SP90402 COVER HINGE PIN SNAP RING 6 6 3.99 2.86 17.16
100-002-868AJ J06006B V-TAC WIDE PADDED SLING, BLACK 6 6 40.95 37.49 224.94
100-005-192AK D27B05B RAIL MOUNT SLING LOOP 6 6 23.00 21.00 126.00
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Please Note: TRANSFER OF THESE PRODUCTS TO ANY INDIVIDUAL OR ENTITY OR LOCATION (WHETHER IN YOUR CITY, STATE,
OR OUTSIDE THE UNITED STATES) MAY BE SUBJECT TO RESTRICTIONS AND/OR LICENSING REQUIREMENTS.
---- ---------------------------------------- *** ORDER ON THE WEB AT www.brownells.com *** ------------
INVOICE #: 09435955.00 ORDER TOTAL: 368.10
UPS - GROUND: 15.95
GRAND TOTAL: 384.05
CASH: 0.00 CC: 0.00 OA: 384.05 COD: 0.00 DUE: 0.00 MB: 0.00 FIC
INDIANA RETAIL TAX EXEMPT PAGE
City o � CERTIFICATE NO.003120155 002 0 11 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 25440
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 REOUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
Brownolls Inc. +Cannal Polito Dap2ttment
VENDOR SHIP 3 Civic Square
20D South Front Street TO Carrel, IN 4
Montezuma, IA 50179
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS - FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42 .40
5 Each Blue fora Gear Rail Mount Sling Loop 900-005-192AK $20.39 $122.34
6 Each VTAC Padded Slings -black 100-002•86OC $37. 9 $224.24
6 Each Ejection Port Cover Binge Pin Snap Ring ?0 $2.86 .
Sub Total: $3".44
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a K
Send Invoice To: A
Carmel Police Department
Attn: Teresa Anderson
3 Civic Square
Carmel, IN 4m PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Police Dept. �� �"; PAYMENT $364.44
r" - A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT/,THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIATION-SUFFICIENT TO PAY-FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. X9/6
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE ± !clef of Pollco
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. V
2' 544�
¢ CLERK TREASURER
DOCUMENT CONTROL NO. A•P. • COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO...__._ -. WARRANT NO.._.._--......._.__.
ALLOWED 20
IN THE SUM.OF$
ON ACCOUNT OF APPROPRIATION FOR
Board Members M
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..-_--------_----
i
d
t
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))
10/23/13 9435955 range supplies $384.05
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.
Brownells Inc. ALLOWED 20
IN SUM OF $
200 South Front Street
Montezuma, IA 50171
$384.05
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25448 I 9435955 I 42-390.10 I $384.05 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
Thursday, October 31, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund