HomeMy WebLinkAbout246214 06/17/15 �% �,q�R� CITY OF CARMEL, INDIANA VENDOR: 369232
ONE CIVIC SQUARE BLACKMORE&BUCKNER ROOFING LLCCHECK AMOUNT: $" ""24,948.38'
:9 _�; CARMEL, INDIANA 46032 1504 SADLIER CIRCLE SOUTH DRIVE CHECK NUMBER: 246214
M,F,uN�, INDIANAPOLIS IN 46239 CHECK DATE: 06/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4350100 SI11895 4,953.38 BUILDING REPAIRS & MA
1205 4350100 32938 SI11895 19,995.00 DOMER REPAIR
BLACKMORE i r
A ECMI�M a rmmPANY INVOICE
Blackmore&Buckner Roofing, LLC Invoice Number: S111895
1504 Sadlier Circle South Drive + Phone:317-263-0707 Invoice Date: 06/09/15
Indianapolis, IN 46239 : Fax: Due Date 06/09/15
www.blackmorebuckner.com Page No: 1
COPY
Bill Ship
To: CITY OF CARMEL To: CITY OF CARMEL
J. BARNES J. BARNES
ONE CIVIC SQUARE ONE CIVIC SQUARE
CARMEL, IN 46032 CARMEL, IN 46032
Ship Via Customer ID CIT130
Ship Date 06/09/15 Customer P.O. 32938
Terms Due Upon Receipt Salesperson PETE PETERSON
Job Description: S111895 ONE CIVIC SQUARE Project No. 14172
Item/Description Unit Order Qty' Quantity Unit Price Total Price
ONE CIVIC SQUARE-ORIGINAL PO 1 1 19,995.00 19,995.00
ONE CIVIC SQUARE- C/O#1 1 1 4,953.38 4,953.38
—3Z,93�s = 1R )9�5
X953 .3-
,��s
21,cT1)g- 'W
Building Maintenance
Account # PO 3;Z 938'
Department # 9za�'
FSubNlmitted �O 15 2015
Clerk Treasurer
Subtotal: 24,948.38
Amount Subject to Amount Exempt Invoice Discount: 0.00
Sales Tax from Sales Tax Tax: 0.00
0.00 24,948.38
Total: 24,948.38
Payments are due on the date specified above as the Due Date. Unpaid invoices shall bear interest at the rate of 1 1/2%per month.
Customer shall be responsible for all costs of collection,including reasonable attorneys'fees incurred due to nonpayment.
INDIANA RETAIL TAX EXEMPT PAGE
®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT r,/
35-60000972 9j
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
jPURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
C
h C_
VENDOR 1 Shcf CJQQ�! I,G f� Vr? +�""' SHIP
TO
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT -
QUANTITY I UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
dl�
"VAU
3 p � 1 ry
r
Send Invoice To-
D,>, C .L),-c ,S�A
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
Z O Jr�l PAYMENT
• 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
THIS APPROR fIO li
SHIP REPAID. FICIENT TO PAY FOOTHE ABOVE ORDER.
•
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. `f J
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLERK-TREASURER
DOCUMENT CONTROL NO- 32938 VENDOR COPY
VOUCHER NO. WARRANT NO.
ALLOWED 20
Blackmore & Buckner Roofing, LLC
IN SUM OF$
1504 Sadlier Circle South Drive
Indianapolis, IN 46239
$24,948.38
ON ACCOUNT OF APPROPRIATION FOR
Administration Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
SI11895 43-501.00 $4,953.38 I hereby certify that the attached invoice(s), or
bill(s) is (are)true and correct and that the
32938 S111895 43-501.00 $19,995.00
materials or services itemized thereon for
which charge is made were ordered and
received except
Monday, June 15, 2015
Director, Administratio
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))
06/09/15 S111895 $4,953.38
06/09/15 S111895 $19,995.00
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