HomeMy WebLinkAbout228805 1/29/2014 CITY OF CARMEL, INDIANA VENDOR: 361470 Page 1 of 1
` ONE CIVIC SQUARE CHILD SOURCE
CARMEL, INDIANA 46032 305 LAKE ROAD CHECK AMOUNT: $472.50
MEDINA OH 44256
CHECK NUMBER: 228805
CHECK DATE: 1/29/2014
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
900 4359005 31434 221170 472 . 50 CAR SEATS
— MERCURY Invoice
DISTRIBUTING
305 Lake Road, Medina, OH 44256
Ph: 330.723.4739 Fax:330.721.6799 Invoice Number: 0000221170
eW'm�, �y,
REM-IMANCLADURESS:� ;-
WSTER RESTRUE�DISTR Invoice 1/16/2014
IB'U�TING. 1N. Date:
e'`dH.MERCURYDIS RIQUT[NG or CI-1I D SOURCE
2/15/2014
30�AKL�RD, Invoice Due Date:
IvIGDINe `OH 44256 Customer: CARMPD
Tax ID 982-0563593 Sales Order: 0000122910
CARMEL POLICE DEPARTMENT,CITY TRINITY CLINIC
3 CIVIC SQUARE 1045 OAKRIDGE ROAD
CARMEL, IN 46032-2584 USA ATT MAGGIE OR NANCY
Cannel, IN 46032 USA
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31434..w„�,...e... .._.. ��a,:»s _,....s.�:._....;� „.:v.�......I7._. ....>"...-a..�r.• �,va:`.:,z,. �..,. .._........_..:s..: Q ..,,•
31434 UPS l ORIGIN Net 30 Days
' N Iter n- .-, _ ;'•e, Descri
•,,Unit Page. r Amount
IC068FSM ON BOARD35 INFANT CAR SEAT W/BASE 2 $ 77.4000 : $ 154.80
3702098 TITAN 5 CARSEAT 50#2PK 4 $ 57.7500 $ 231.00
- - - -- -------- ------------------------- -- LAST ITEM - -
it
Tracking Numbers: 1ZA7T6670395664693, 1ZA7T6670396973688, 1ZA7T6670397144876, 1ZA7T6670397781900
Subtotal 385.80
Freight 86.70
Sales Tax 0.00
Discount 0.00
Payment/Credit Amount 0.00
jES. z, ;xµ alarice_Due 472.50
INDIANA RETAIL TAX EXEMPT PAGE
City of CCERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 39434
35-60000972
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
9F9512a'14
Ih
adVENDORpp@SIdm ft$@Pw® DIOrbutInp, Inc. SHIP
TO
PA. Son 73794 Camol, IN 46= '
Cietislmd, ®FI 44993i.Nancy
CONFIRMATION B=UNIT
PAYMENTTERMS -FREIGHT
QUANTITY DESCRIPTION UNIT PRICE EXTENSION
Account M .06
I Each shipping $88.70 $88.70
4 Each Titan 5 Carseat 3702098 $57.75 $239.00
2 Each On Board35 Infant Car Seat iC008FSI $77.40 $9544.80
� i � .
� Sub Total: $472.50
� a
Cc, - :
Send Invoice To: �f
Cunol Pollco Dep2rkmont
Attn: Pat Young
3 CIVIC squm
Cwnd, IN 40032= PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Cairmel Police Dept. C, PAYMENT $472.50
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID.
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
� •
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY �AJ
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL -
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLEChid of Pollco
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO. 3 1 4 3 4 A.P.V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT
ALLOWED 20
IN THE SUM OF$
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
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))
01/16/14 0000221170 car seats $387.08
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
Child Source
Western Reserve Distributing, Inc. IN SUM OF $
P.O,. Box 73714
Cleveland, OH 44193
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Grant Fund
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
31434 I 0000221170 I -590.05 I $387.08 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, nuary 23, 2014
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund