HomeMy WebLinkAbout240121 12/09/14 J�! CITY OF CARMEL, INDIANA VENDOR: 363840
® i1 ONE CIVIC SQUARE STATE SAFETY &COMPLIANCE LLC CHECK AMOUNT: $.......499.09'
CARMEL, INDIANA 46032 5338 VICTORY DRIVE STE A CHECK NUMBER: 240121
INDIANAPOLIS IN 46203 CHECK DATE: 12/09/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 10208847 321.23 OTHER EXPENSES
651 5023990 10209375 177.86 OTHER EXPENSES
INVOICE
State Safety& Compliance, LLC.
INVOICE
Branch: 701 Indianapolis 10209375
5358 Victory Dr Invoice Date Page
Indianapolis,IN 46203 11/20/2014 15:52:49 1 of 1
ORDER NUMBER
3828864
317-423-7724
Bill To: Ship To: **DIRECT SHIPMENT**
Carmel Waste Water Treatment Carmel Waste Water Treatment
Attn: Paul Amone Carmel W.W.T.Attn: DUANE JARVIS
9609 Hazel Dell Parkway 9609 Hazel Dell Parkway(PO S14520)
Indianapolis,IN 46280 Indianapolis,In 46280
--Customer 1D:-109095-------
PO
9095 ------PO Number Terms Description Net Due Date Disc Due Date Discount Amount
S14520 0.5% 10 net 30 12/20/14 11/30/14 0.81
Order Date Pick Ticket No Primary Salesrep Name Taker
11/5/2014 16:14:51 6215340 Gary Smith JCHANEY
Quantities Pricing
Item ID POM Unit Extended
Ordered Shipped Remaining UOM a Item Description Unit Size Price Price
Unit Size O
Delivery Instructions. UPS GROUND PREPAY&ADD
Carrier. UPS Ground-PPA Tracking#:1Z09X9240372453836
1.0000 1.0000 0.0000 EA OCC-LUX-TJBJ-XL EA 53.7500 53.75
1.0 JACKET BOMBER YLW CL 3;RFLTV STRIPES 1
2.0000 2.0000 0.0000 EA OCC-LUX-TJBJ-2XL EA 53.7500 107.50
1.0 JACKET BOMBER YLW CL 3;RFLTV STRIPES 1
Total Lines:2 SUB-TOTAL: 161.25
Total FiWght-ln:0.00- Total Freiglit Out:16.61 TOTAL FREIGHT. 16.61
TAX. 0.00
AMOUNT DUE: 177.86
ORIGINAL
INVOICE
State Safety& Compliance, LLC.
INVOICE
Branch: 701 Indianapolis 10208847
5358 Victory Dr Invoice Date Page
Indianapolis,IN 46203 11/19/2014 15:34:471 1 of 1
ORDER NUMBER
3828864
317-423-7724
Bill To: Ship To:
Carmel Waste Water Treatment Carmel Waste Water Treatment
Attn: Paul Arnone Carmel W.W.T.Attn: DUANE JARVIS
9609 Hazel Dell Parkway 9609 Hazel Dell Parkway(PO 514520)
Indianapolis,IN 46280 Indianapolis,In 46280
-Cust0mer-11D:-1-0909
PO Number Terms Description Net Due Date Disc Due Date Discount Amount
514520 0.5% 10 net 30 12/19/14 11/29/14 1.55
Order Date Pick Ticket No Primary Salesrep Name Taker
11/5/2014 16:14:51 6214748 Gary Smith JCHANEY
Quantities Pricing
Item ID UOM Unit Extended
Ordered Shipped Remaining UOM a Item Description Unit Size Price Price
Unit Size O
Delivery Instructions: UPS GROUND PREPAY&ADD
Carrier: UPS Ground-PPA Tracking#:1 z203yOaO3 67925916
3.0000 3.0000 0.0000 EA SP-TF4577/UAK EA 103.0000 309.00
1.0 HARNESS T-FLEX STRETCH UNIVSAL BCK DRING 1
TONGUE BUCKLE LEGS; MATING BUCKLE
CHEST&SHOULDER STRAPS; SUB-PELVIC
STRAP; SLIDING BACK D-RING&W/BELT
Total Lines:l SUB-TOTAL: 309.00
Total Freight In:0.00 Total Freight Out:12.23 — TOTAL FREIGHT: 12.23
TAX. 0.00
AMOUNT DUE: 321.23
ORIGINAL
VOUCHER # 146090 WARRANT # + ALLOWED
363840 IN SUM OF $
STATE SAFETY & COMPLIANCE LLC
5338 VICTORY DRIVE STE A
INDIANAPOLIS, IN 46203
I
Carmel Wastewater Utility
I
ON ACCOUNT OF APPROPRIATION FOR
;I
Board members
i
PO# INV# ACCT# AMOUNT Audit Trail Code
10208847 01-7202-06 $321.23
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99,o)
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Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund 4
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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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
363840
STATE SAFETY& COMPLIANCE LLC Purchase Order No.
5338 VICTORY DRIVE STE A Terms
INDIANAPOLIS, IN 46203 Due Date 12/3/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/3/2014 10208847 $321.23
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
y-'& /
Date Officer