226244 11/19/2013 CITY OF CARMEL, INDIANA VENDOR: 360427 Page 1 of 1
0 ONE CIVIC SQUARE THE BOX COMPANY
CARMEL, INDIANA 46032 616 STATION DR CHECK AMOUNT: $238.64
?� CARMEL IN 46032
CHECK NUMBER: 226244
CHECK DATE: 11/1912013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4342100 CFD103013 112 .47 POSTAGE
1110 4342100 CPD7102913 126 . 17 POSTAGE
a
616 Station Drive The Box Company Phone: 317-846-7467
Carmel, IN 46032 p y Fax: 317-846-7468
Name: Carmel Police Dept. Phone Number: 317-571-2500 Date: 10/29/2013
Address: 3 Civic Square
City: Carmel State: IN. Zip: 46032 Invoice M CPD7102913
Qt . Description Unit Price Total
Shipping Charges(attached) $ 123.67
Packaging Charges (attached) $ _
1 Shipping Envelope 2.50 $ 2.50
$ O
C
$ -
$
$
$ �.
$ -0
$ :3
$ - (Q
$ U)
$ -0
(D
$ n
$ _$ N
$ cn
$
Sub Total $ 126.17
o% Discount
Thank You for Your Order! After Discount
6%Sales Tax $ -
Total $ 126.17
i U
O -So-13 BOXFRM-01(10/06)
CO DEPT DATE NO
PACKAGE SHIPPING REQUEST
NAME
THE BOX COMPANY S (LAQ, pale-f-
616 Station Drive E STREET ADDRESS
Carmel,In 46032 N 3 eloj6
D CITY,STATE,ZIP
E"r37 �L iv Z169)3 Z
(317)846-7467 FAX(317)846-7468 RNE,WORK PHONE
Internethttp://www.boxco.com 671-25-00 yx'o j1J$gJ
PKG DESCRIPTION OF DE oAR sDVALUE SEND TO v
NO PACKAGE CONTENTS YOU WANT ADD'LINS
NAME $ PKG WT $ CARRIER
A77M 1ZrHA Paa—,>z,eg:---. (MA 1321 g�1 CHARGES
1 STREET ADDRESS $
J OO ADDITIONAL
ZONE � INSURANCE
CITY,STATE,ZIP p/ $ HANDLING
�bi i� L� /�z- �SZ J�$�!(�Q ■ CHARGE
NAME $ PKG WT $ CARRIER
CHARGES
2 STREET ADDRESS $ ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $ ■ HANDLING
CHARGE
NAME $ PKG WT $ CARRIER
CHARGES
3 STREET ADDRESS $
ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $ HANDLING
CHARGE
NAME $ PKG WT $ CARRIER
CHARGES
4 STREET ADDRESS $
ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $ HANDLING
CHARGE
ATTENTION CUSTOMERS!!
PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL
PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE
A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED
$25,000 IN VALUE.
• 2S �c — 3 BOXFRM-01(10/06)
CO DEPT I DATE NO
PACKAGE SHIPPING REQUEST
NAME
THEBOX COMPANY S (!Af 44f& PoCicg t)F-pr
616 Station Drive E STREET ADDRESS
Carmel,In 46032 N 3 C/U(G S&(GAR.6
D CITY,STATE,ZIP
E x`/44C-e 1Aj Y(-032--
(317)846-7467 FAX(317)846-7468 R H E PHONE_,WORK PHONE
Internet http://www.boxco.com 317) S
PKG SEND TO DESCRIPTION OF DE LAR$DoANO E
NO PACKAGE CONTENTS YOU WANT ADDT INS
NAME $ PK WT $ CARRIER
19TAPoIL Nei uS—C(Z(ES //JG CHARGES
1 STREET ADDRESS '
ADDITIONAL
lvc> Alu in S/ NE INSURANCE
CITY,STATE,ZIP $
/US 073-0 HANDLING
CHARGE
NAME $ PK WT $ ■ CARRIER
CHARGES
2 STREET ADDRESS $ ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $ HANDLING
CHARGE
NAME $ PKG WT $ CARRIER
CHARGES
3 STREET ADDRESS $ ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $ • HANDLING
CHARGE
NAME $ PKG WT $ CARRIER
CHARGES
4 STREET ADDRESS $
ADDITIONAL
ZONE • INSURANCE
CITY STATE,ZIP $ HANDLING
CHARGE
ATTENTION CUSTOMERS!!
PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL
PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE
A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED
$25,000 IN VALUE.
• g-z9-/3 BOXFRM-01(10/06)
CO DEPT DATE NO
PACKAGE SHIPPING REQUEST
NAME
THE BOX COMPANY S CAUsL POCIC$-7 A'->F-FA-a:AfC-JT
616 Station Drive E STREET ADDRESS
Carmel,In 46032 N 3
D CITY,STATE,ZIP
E ea v- 1Aj �l003 Z
(317)846-7467 FAX(317)846-7468 R HOME PHONE,WORK PHONE n
Internet http://www.boxco.com 317, S 71— Z So o
PKG SEND TO DESCRIPTION OF DE OVER$1D00 AND E
NO PACKAGE CONTENTS YOU WANT ADD'LINS
NAME $ PKG WT $/y CARRIER
A-MrAl' RAMA'�) /wA)%a"O"q'/$Z f Vy I .L � CHARGES/2
1 STREET ADDRESS $ ADDITIONAL
Zoo Al ZONE INSURANCE
-P7�T7Y, TATE,ZIP" �1 ! $ HANDLING
% LwLE /t Z 4SS2 SS 9bQ 3 CHARGE
NAME $ PKG WT $ CARRIER
CHARGES
STREETADDRESS $ ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $ HANDLING
CHARGE
NAME $ PKG WT $ CARRIER
CHARGES
3 STREET ADDRESS $
ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $ HANDLING
CHARGE
NAME $ PKG WT $ CARRIER
CHARGES
4 STREET ADDRESS $
ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $
HANDLING
CHARGE
ATTENTION CUSTOMERS!!
PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL
PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE
A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED
$25,000 IN VALUE.
• BOXFRM-01(10/06)
CO DEPT DATE NO
PACKAGE SHIPPING REQUEST
- NAME
THE BOX COMPANY S Cu v►tee
616 Station Drive E STREET ADDRESS
Carmel, In 46032 N
D CITY,STATE,ZIP
E
(317)846-7467 FAX (317)846-7468 R HOME PHONE,WORK PHONE
Internet http://www.boxco.com
PKG SEND TO DESCRIPTION OF DECLARED R 1 VALUE
NO PACKAGE CONTENTS YOU WANT ADD'L INS
NAME PKG W7 $ CARRIER
C 5 C_1 ✓ct vt-4 CHARGES
STREET DDRESS $ ADDITIONAL
1
STREET
'1�1rsI ZONE INSURANCE
CITY,STATE,7� ! ' `) r h < �� $ HANDLING
3 V I CHARGE
NAME ` P t / / / V r Q PKG WT $ CARRIER
1 1 �V} CHARGES
2 STREET ADDRESS I�� $ ADDITIONAL
�l7 ZONE INSURANCE
CITY,STATE,ZIP �� /�� $ HANDLING
CHARGE
NAME / P G WT $ CARRIER
I CHARGES
3 STREET ADDRESS $ ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $ HANDLING
CHARGE
NAME $ PKG WT S CARRIER
CHARGES
A STREET ADDRESS $ ADDITIONAL
4 ZONE INSURANCE
CITY,STATE.ZIP $ HANDLING
CHARGE
ATTENTION CUSTOMERS!!
PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL
PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE
A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED
$25,000 IN VALUE.
CO DEPT 13 BOXFRM-01 (10/06)
PACKAGE SHIPPING REQUEST DATE NO
NAME
THEBOX C®MPANY S CARMEL POLICE DEPT
616 Station Drive E STREET ADDRESS 3 C I V I C S QUAR E
Carmel, In 46032 N
D CITY,STATE,ZIP CARA
E
(317)846-7467 FAX(317)846-7468 R HOME PHONE,WORK PHONE
Internet http://www.boxco.corn (317 :5-7/ -,Z�do �Z ,,�;,} cTg&J-sp"o
PKG
iNO SEND TO DESCRIPTION OF DIFCoL�AERR SDI ALo E
NAME 7A569, /N £2,-�q PACKAGE CONTENTS YOU WANT ADD'LINS
i(on�/�L
$ PKG WT $ CARRIER
/Q77�l: QMi4 l7£.PAQT•JLcE�T IC�'NA I�YC�/�
J STREET ADDRESS CHARGES
1 17800 14 15st`l, 5T ADDITIONAL
CITY,STATE,ZIP ZONE INSURANCE
SGC[IS7�L>= XZ V5255-9(603 —� $ HANDLING
NAME CHARGE
P G WT $ CARRIER
^ STREET ADDRESS CHARGES
L $ ADDITIONAL
Y,STATE,ZIP ZONE INSURANCE
CIT
$ HANDLING
NAME CHARGE
$ PKG WT $ CARRIER
^ STREET ADDRESS CHARGES
3 $ ADDITIONAL
CITY,STATE,ZIP ZONE n INSURANCE
i $ HANDLING
NAME CHARGE
$ PKG WT $
- CARRIER
A STREET ADDRESS CHARGES
L} $ ADDITIONAL
i
CITY,STATE,ZIP ZONE INSURANCE
$
HANDLING
CHARGE
! ATTENTION CUSTOMERSII
PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL
PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE
13OXFRM-01(10/06)
PACKAGE SHIPPING REQUEST CID DEPT DATE N
THE BOX COMPANY S NAME
616 Station Drive E STREETADDRE$SARME� °OLICE DEPT
Carmel, In 46032 N (,
D CITY STATE,ZI
E CARMEL, IN 46032
(317)846-7467 FAX(317)846-7468 R HO E PHONE,WORK PHONE
iInternethttp://www.boxco.com 3l�) Sr7�_Z .}ao
PKG 7
NO SEND TO DESCRIPTION OF DECLARED F 5100 AND E
[NAME PACKAGE CONTENTS YOU WANT ADD'L INS
�A-y C t7Z£
$ PKG W7 $ . ��CARRIER
STREET ADDRESS CHARGES
35y9 IV JE:em16L1,) 5%, $ ADDITIONAL
CITY,STATE,ZIP ONE INSURANCE
4J�/JUC L.. L J7 - 70 HANDLING
NAME CHARGE
PKG WT $ CARRIER
^ STREET ADDRESS CHARGES
L $ ADDITIONAL
CITY,STATE,ZIP ZONE INSURANCE
$ HANDLING
NAME CHARGE
PKG WT $ CARRIER
^ STREET ADDRESS CHARGES
3 $ ADDITIONAL
CITY,STATE,ZIP ZONE INSURANCE
i $ HANDLING
NAME I CHARGE
PKG WT $ CARRIER
4 STREET ADDRESS CHARGES
$ ADDITIONAL
CITY,STATE,ZIP ZONE INSURANCE
$ HANDLING
�
ATTENTION CUSTOMERSII CHARGE
PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM.
PLEASE DECLARE THE VALUE OTAL
INTEND TO PURCHASE INSURANC
E OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU E TO COVER CHARGE
� A PAC:KAr;F WHIt,H HnR A v4i i iF rnrGq Tur rnvoiroe,t�e,TCfl Penn,,non,r. ,,,...,,,,,,,,.,.,,�.,...r� •... '.,,,,��,�
BOXFRM-01(10/06)
PACKAGE SHIPPING REQUEST DEPT DATE NO
1 HE L®A C®MPA \Y S NAME
616 Station Drive E STREET AD�R V�C SQUARE
POLICE DEPT
I Carmel, In 46032 N
D CITY STAT
E
(317)846-7467 FAX(317)846-7468 R HO� PHONE
Internethttp://www.boxco.com h17� ,WORK PHONE nn
PKG
iNO SEND TO DESCRIPTION OF DECLARED o A
NAME
LAREDVALUE
PACKAGE CONTENTS IF YOU WANT ADD'L INS
iGk14Q.Zj (�o'ptjy/
$ PKG WT $i '� rnRRIER
�S F vTau PAL« �E(�t+1z `I cE,� T CHARGES
J STREET ADDRESS
l $ ADDITIONAL
(pD/ `���� �T� / Z �/ INSURANCE
CITY,STATE,ZIP
�TO^-� l K- �� $ HANDLING
NAME, /CsHARGE
LA1—(L q o PKG WT $ � CARRIER
Sly
STREADDRESS
CHARGES
L $✓ZO`U { ST 5
ADDITIONAL
CITY STAI E,ZIP ZO�f 12 INSURANCE
T37tl HANDLING
NAME CHARGE
$ PKG WT $
' CARRIER
STREET ADDRESS , CHARGES
3 $
ADDITIONAL
CITY,STATE,ZIP ZONE INSURANCE
$ HANDLING
NAME CHARGE
$ PKG WT $
CARRIER
STREET ADDRESS CHARGES
$ ADDITIONAL
CITY,STATE,ZIP ZONE INSURANCE
$ HANDLING
CHARGE
ATTENTION CUSTOMERSII
PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM.
PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE TOTAL
A PAr:KAr;F WHir. E INSURANCE TO COVER CHARGE
HHA.CG1/GIIIF(1)/CD'iIJC(`A�OICO'CII�iRCn Pw/�/111�0111'TV wnvlw•I I����`ir^w^r-...ww,.,,��.
CO DEPT DAT 1 NO
PACKAGE SHIPPING REQUEST ���
NAME v//
THE BOX COMPANY S �' o
616 Station Drive E STREET ADDRESS
Carmel, In 46032 N
D CITY,STATE,ZIP
E
(317)846-7467 FAX(317)846-7468 R HOME PHONE,WORK PHONE
Internet http://www.boxco.com
PKG SEND TO DESCRIPTION OF DE OVAR D0 ANO E$10
NO PACKAGE CONTENTS YOU WANT ADD'L INS
NAME / $ PKG-WT $ 2 CARRIER
/'"I ero" - �`/ CHARGES
STREET ADDRESS /) / r / ADDITIONAL
1
s y h
7 ZONE INSURANCE
CITY,STAT ,ZIP $ HANDLING
C-A UI I� CHARGE
NAME $ PKG WT $ CARRIER
CHARGES
STREET ADDRESS $ ADDITIONAL
2 ZONE INSURANCE
(CITY,STATE.ZIP $ HANDLING
CHARGE
NAME $ PKG WT S CARRIER
CHARGES
3 STREET ADDRESS S ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $ HANDLING
CHARGE
NAME $ PKG WT $ CARRIER
CHARGES
4 STREET ADDRESS 5
ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $ HANDLING
CHARGE
ATTENTION CUSTOMERS!!
PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL
PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE
A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED
$25,000 IN VALUE.
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))
10/29/13 CPD7102913 shipping charges $126.17
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
The Box Company
IN SUM OF $
616 Station Drive
Carmel, IN 46032
$126.17
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT _ Board Members
1110 I CPD7102913 I 43-421.00 I $126.17 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, November 14, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
616 Station Drive The Box Company Phone: 317-846-7467
Carmel, IN 46032 Fax: 317-846-7468
Name: Carmel Fire Department Phone Number 571-2600 Date: 10/30/2013
Address: 2 Civic Square Fax Number P.O. Number
City: Carmel State: IN Zip: 46032 Invoice#: CFD103013
Qt V. Description Unit Price Total
IShipping Charges(attached) $ 112.47
Packaging Charge(attached) $ -
$
O
$ - C
$
$ - Cn
$
$ - -0
$
$
(Q
$ U)
$ _ -0
(D
$ - (7
$
$ _ (n
$ - (A
$ -
Sub Total $ 112.47
o-io Discount
Thank You for Your Order! After Discount
0% Sales Tax
Total $ 112.47
PACKAGE SHIPPING REQUEST CO DE7PHONE BOXFRM-01(10/i
THE NAME O s 616 Station D rive E STREE7 ADDRESCarmel, In 46032 N D CITY,STATE,ZIP E(317)846-7467 FAX (31 7) 846-7468 R HOME PHONE,W
Internet httP://www.boxco.com
PKG
NO SEND TO DESCRIPTION OF DECLARED VALUE
NAME PACKAGE CONTENTS IF OVER S100 AND
f' C YOU WANT ADD-L INS
"t S mC(vt/ $ PKG WT 5
1 STREET ADDRESS .� CHARGES
CITY,STATE,ZIP E ADDITIONAL
ZON INSURANCE
NAME ^ HANDLING
PKG WT $ CHARGE
2 STREET ADDRESS CARRIER
CHARGES
S
Y,S ADDITIONAL
CITT A TE,ZIP ZONE INSURANCE
NAME S HANDLING
CHARGE
3 STREET ADDRESS PKG WT 5 CARRIER
CHARGES
5
CITY,STATE,ZIP ZONE ADDITIONAL
INSURANCE
NAME 5 HANDLING
CHARGE
PKG WT —
4 STREET ADDRESS CARRIER
CHARGES
5
ZONE ADDITIONAL
CITY,STATE,ZIP
INSURANCE
S HANDLING
ATTENTION CUSTOMERS!! CHARGE
PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM.
PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE
A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED TOTAL
525,000 IN VALUE.
CO LG'l,FkPA-UI;7G/GE
PACKAGE SHIPPING REQUEST DEPT DATE J NO
THE BOX COMPANY NAME ` ---
s
616 Station Drive F STREET ADDRESS -----.-
Carmel,In 46032 N "�9�1^
U CITY,STATE.ZIP v
E
(31 7)845-7467 FAX (31 7)846-7468 R HOME PHONE,WORK PHONE
Internet http://www.boxco.com —
?KG
SEND TO DESCRIPTION OF DECLARED VALUE
- PACKAGE CONTENTS IF OVER 5700 AND
i NAM YOU WANT ADD'L INS
$ PKG VJ S
/ 7' L-HA RIEP.
STREET ADDRESS ( ((_�..t�ARRI ES
CITY STATE,ZIP ZON ADDITIONAL E INSURANCE
S ----
INAME HANDLING
CHARGE
PKG Vtrr S CARRIER
2 STREET ADDRESS CHARGES
__.. S ADDITIONAL
_
INSURANCE
- -
1. Fill-in all inf rmation on this form.
2. Print out (4) copies.
Send (3) copies with the item(s) you are sending back for repair, and keep (1) copy for your records.
3. Please ensu returned item(s) are well packaged. Try to use the original packaging material whenever possible.
4. Return items) r repair to the following address: /
Kussmaul Electronics Company Inc.
Attn: Repair Department Cl!
170 Cherry Avenue
West Sayville, N.Y. 11796
Print Form
All service repairs are covered by a 180 Day Warranty Period. For your convenience,we offer a downloadable Repair Charge Price List for the majority of our
products on the Contact Us page of our web-site. If an item exceeds the cost on the Repair Charge Price List, you will be notified first for authorization to
proceed,otherwise you will be automatically charged the Standard Repair Charge plus the cost of shipping the item(s)back.
If your charger is found to be beyond economical repair, you will be contacted to determine if you would like us to scrap the unit or return it back to you
unrepaired. If 10 business days have passed without a response, the charger will be returned unrepaired at your expense. Your prompt reply to this matter
will be greatly appreciated.
Tracking Number: Received By:
Parts Missing: With: Without: Physical Inspection:
Indicator Line Cord Cut
Cable Chassis Bent
Dog Heuse \Afatpr rlamanp
Other Other
• BOXFRM-01(10/C
"ten CO DEPT DATE �' NO
PACKAGE SHIPPING REQUEST I I I v d
NAME
THEP®X COMPANY
616 Station Drive E STREET ADDRESS
Carmel, In 46032 N
D CITY,STATE,ZIP
E
(317)846-7467 FAX(317)846-7468 R HOME PHONE,WORK PHONE
Internet http://www.boxco.com
PKG DESCRIPTION OF DECLARED VALUE E
SEND TO NO PACKAGE CONTENTS YOU WANT ADD'L INS
NAME $ PKG WT $ ARRIER
ARG ES
VIKC
i STREET ADDRESS S ADDITIONA
1 Kalb Ip�/� S P I-� ZON INSURANC
CITY,STATE,�j�P I / $ HANDLINC
/ n 5T CHARGE
NAME l v� �` fff V $ PKG WT $ CARRIER
( f CHARGES
STREET ADDRESS I G` / $ ADDITIONA
ZONE INSURANC
CITY STATE,ZIP „•I / n/ HANDLING
U 1/.�, Y CHARGE
NAME $
PKG WT $ CARRIER
CHARGES
STREET ADDRESS $ ADDITIONA
3
ZONE INSURANCI
CITY,STATE,ZIP $ HANDLING
CHARGE
NAME $ PKG WT $ CARRIER
CHARGES
q STREET ADDRESS $ ADDITIONA
4 ZONE INSURANCI
CITY,STATE,ZIP $ HANDLING
CHARGE
ATTENTION CUSTOMERS!!
PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL
PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE
A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED
$25,000 IN VALUE.
I
1
BOXFRM-01(10106)
PACKAGE SHIPPING REQUEST CO DEPT DATE NO/h D
NAME
THE BOX COMPANY S
616 Station Drive E
STREET ADDRESS'
Carmel, In 46032 N
D CITY,STATE,ZIP
E
(317)846-7467 FAX (317)846-7468 R HOME.PHONE,WORK PHONE
Internet http://www.boxco.com -3 r� "" CpQd
PKG SEND TO DESCRIPTION OF DECLARED VALUE
NO PACKAGE CONTENTS YOU WANT 100 AND
NAME Q
/ t 114 ZD►'1 �7Y1 $ PKG �aqADDITIONAL
ARRIER
HARGES
STREET DDRES L(
1 TI/ e �44`ee j
(� C� 1 ONE INSURANCE
CITY T
�Iv\
i ! I
L
/I[\ $ HANDLING
CHARGE
NAME PKG WT $
$ CARRIER
CHARGES
^ STREET ADDRESS
L $ ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP
$ HANDLING
CHARGE
NAME PKG WT $
$ CARRIER
STREET ADDRESS CHARGES
3
$ ADDITIONAL
CITY,STATE,ZIP ZONE INSURANCE
$ HANDLING
CHARGE
NAME PKG`NT $
$ CARRIER
4 STREET ADDRESS CHARGES
$ ADDITIONAL
CITY,STATE,ZIP ZONE INSURANCE
$ HANDLING
CHARGE
ATTENTION CUSTOMERSN
PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM.
TOTAL
PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE
A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED
$25,000 IN VALUE.
I
Y BOXFRM•01(10106)
PACKAGE SHIPPING REQUEST CO DEPT DATE NO
D
THE BOX COMPANY S NAME
616 Station Drive E STREET ADDRESS
Carmel,In 46032 N
D CITY,STATE,ZIP
E
(317)846-7467 FAX(317)846-7468 R HOME PHONE,WORK PHONE
Internet http://www.boxco.com
PKG SEND TO DESCRIPTION OF DE LARiDoAL E
NO PACKAGE CONTENTS YOU WANT ADD'L INS
NAME G $ PKG�WT $. ?0 CHARGES
1 STREET ADDRESS $
ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $
HANDLING
CHARGE
NAME $ PKb WT $ CARRIER
CHARGES
2 STREET ADDRESS $ ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $
HANDLING
CHARGE
NAME $ PKG WT $ CARRIER
CHARGES
3 STREET ADDRESS $
ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $ • HANDLING
CHARGE
NAME $ PKG WT $
CARRIER
CHARGES
4 STREET ADDRESS $
ADDITIONAL
ZONE INSURANCE
CITY,STATE,ZIP $
HANDLING
CHARGE
ATTENTION CUSTOMERSII
PLEASE COMPLETE ALL WHITE AREAS ON THIS FORM. TOTAL
PLEASE DECLARE THE VALUE OF THE PACKAGE(S)YOU ARE SHIPPING IF YOU INTEND TO PURCHASE INSURANCE TO COVER CHARGE
A PACKAGE WHICH HAS A VALUE OVER THE CARRIER'S LIMITED$100 LIABILITY.MAXIMUM COVERAGE CANNOT EXCEED
$25,000 IN VALUE. •
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))
CFD103013 $112.47
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
The Box Company
IN SUM OF $
616 Station Drive
Carmel, IN 46032
$112.47
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
1120 I CFD103013 I 43-421.00 I $112.47 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—NOV 1 8 28
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund