226245 11/19/2013 CITY OF CARMEL, INDIANA VENDOR: 003000 Page 1 of 1
ONE CIVIC SQUARE BOYCE INC CHECK AMOUNT: $522.82
i�4a CARMEL, INDIANA 46032 P 0.BOX 669
DALEVILLE IN 47334-0669 CHECK NUMBER: 226245
CHECK DATE: 11/19/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4230000 25440 0436882-IN 522 . 82 NCR RECIPTS
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t* Boyce Forms / Systems 800-382-8702 Invoice
Boyce P.O. Box 669 317-664-7400 (Ph)
0 Daleville, IN 47334-0669 317-664-7401 (Fx) 0436882-IN
10/31/2013
B S
I CARMEL POLICE DEPT H CARMEL POLICE DEPT
L #3 CIVIC SQUARE 1 #3 CIVIC SQUARE
L ATTN: TERESA ANDERSON P CARMEL, IN 46032
CARMEL, IN 46032
T T
O O
CUSTOMER ICUSTOMER POI TERMS I SALES ORDER I ORDER DATE I SALESMAN I SHIP VIA 1 FOB
0765466 25440 Net 10 0113252 10/21/13 0007 UPS-COM
ITEM / DESCRIPTION UM ORDERED SHIPPED BACKORDERED UNIT PRICE EXTENDED PRICE
FM352-2-BK BK 20.00 20.00 0.00 510.90
352 GENERAL FUND RCPTS
2PT WHI/CAN CBNLS 30N BK,
#58301 -61300
X1337 Y3912
TIME TO ORDER YOUR 2013 TAX FORMS
Net Invoice I Less Discount Freight Sales Tax Invoice Total Less Deposit Invoice Balance
®5�,n An n.nn 1 i_Q, n.nn _522.82 0..0.0 _ 522.82
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INDIANA RETAIL TAX EXEMPT PAGE
City o ''IC°�anal CERTIFICATE NO.003120155 002 0 CS�s. 1i PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT
35-60000972 25440
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
A.S. Says@ Co., Inc. Catynel Police Department
VENDOR SHIP 3 Civic Squaris
TO
P•0, Box 669 Carmel, IN
Dallovilie, IN 47: (317)571-2%9
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 42-M.00
20 Each 352 White NCR Receipts U0924 $25.55 $510.90
Sub Total: $510.90
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Send Invoice To:
Carmel Police Department
Attn: Terrisa Anderson
3 Civic Squam
Camel, IN 4e PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel Relics Dept. PAYMENT $510.90
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN BLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATION�SUFFICIENT TO PAY FOR THE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED.
• ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE hief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
22 5 4 4® CLERK-TREASURER
DOCUMENT CONTROL NO. A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO.---,._-....-.._.. - WARRANT NO.....-._.__.... -
ALLOWED 20
IN THE SUM OF$
_ I
ON ACCOUNT OF APPROPRIATION FOR
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
0
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
I
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s)) .
10/31/13 0436882-IN Receipts $522.82
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
120
Clerk-Treasurer
I
VOUCHER NO. WARRANT NO.
ALLOWED 20
Boyce Forms/Systems
IN SUM OF $
P.O. Box 669
Daleville, IN 47334-0669
$522.82
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO#/Dept. INVOICE NO. ACCT#!TITLE AMOUNT Board Members
25440 I 0436882-IN I 42-300.00 I $522.82 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
Thursday, November 14, 2013
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund