225956 11/05/2013 CITY OF CARMEL, INDIANA VENDOR: 363645 Page 1 of 1
ONE CIVIC SQUARE RIMAGE CORPORATION CHECK AMOUNT: $416.70
9 =a CARMEL, INDIANA 46032 NW5255
PO BOX 1450 CHECK NUMBER: 225956
MINNEAPOLIS MN 55485-5255
CHECK DATE: 11/5/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4230200 25438 90126883 416 . 70 DVD EVEREST WHITE
Page 1 of 1
Phone: 1-800-445-8288 10/15/2013 22:00:37
R I M A G E° Fax: 952-400-0939
Internet: www.quma.com
Invoice
Sold To:party Info .
rrnation
CITY OF CARMEL POLICE DEPT. Invoice Number/Date 901 26883 10/15/2013
3 CIVIC SQUARE Delivery Number/Date 80182723 10/15/2013
CARMEL IN 46032 Sales Order Number/Date 10073037 10/15/2013
PO Number 25438
PO Date 10/15/2013
Customer No. 120998
....1p To.;Party Invoice Amt 416.70 USD
CITY OF CARMEL POLICE DEPT. Term of Payment Net due in 30 days
3 CIVIC SQUARE Incoterm FOB DESTINATION
CARMEL IN 46032 Gross Weight 40.000 LB
Carrier FedEx Tracking
Bill of Lading 574176904529
Rimage Contact Tracey Dietsch
Customer Contact: Todd Luckoski
tiuckoski @carmel.in.gov 317-571-2590
Item Material/Description Quantity Unit Price Value
10 2002472 10 EA 41.67 416.70
DVD-R Everest White (100 pack)
100 count shrink-wrapped stack of white DVDs optimized for Rimage
Everest thermal printers.
Subtotal 416.70
Drop Ship 0.00
Freight 0.00
Tax 0.00
Total Invoice Amount 416.70
Wells Fargo Bank, N.A. Please Remit Payment to:
Minneapolis, MN Account#4100163674 Rimage Corporation
ABA Routing # 121000248 S.W.I,F.T. WFBIUS6S NW5255 PO Box 1450
Federal ID #41-1577970 Minneapolis, MN 55485-5255
DUNS# 15-177-2530
GSA Contract#: GS-35F-0537P Thank you for your business.
All sales of Rimage products are subject to the terms of the RIMAGE SALES TERMS AND CONDITIONS which may be found at
www.qumu.com/legal.By purchasing the Rimage productis)specified in this document,you accept and agree to the RIMAGE SALES TERMS
AND CONDITIONS. Freight Charges include taxes,duties and brokerage fees which are not refundable in the event of a return. Rimage reserves
the right to send a supplemental invoice for additional freight expenses incurred after the actual ship date.
C0 INDIANA RETAIL TAX EXEMPT PAGE
ity o Carmel CERTIFICATE NO.003120155 002 0 11 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
1013
Mr ag@ Corporation Camel Police Department
VENDOR TOIP 3 Civic Square
7725 Washington Avenue South Camel, IN 46032
Minnoapolls, MN 5543' (317)q7i 'i9
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-M2.01
10 Each DVD-R Everest Mile 2002472 $441.67 $416.70
8'ub Total: $416.70
6
g F �•
N1111q
Send Invoice To:
Camel Police Depatrtmont
Attn:Teresa Anderson
3 Civic Satre
Corbel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
Carmel Police Dept. . A PAYMENT $416.70
'\ A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THEREIS AN UNOBLIGATED BALANCE IN
THIS APP OPAIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•SHIP REPAID.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. '
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS. /� r
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE ( Chief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. V
I'�j 4 3 CLERK-TREASURER
DOCUMENT CONTROL NO. A.P. • COPY-SIGN AND RETURN TO CLERIC'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN THE SUM OF$
ON ACCOUNT OF APPROPRIATION FOR
- a
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Rimage Corporation
IN SUM OF $
7725 Washington Avenue South
Minneapolis, MN 55439
$416.70
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
25438 I 90126883 I 42-302.00 I $416.70 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
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))
10/15/13 90126883 DVD's $416.70
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