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Home My WebLink About254084 02/05/16 +w..G4gy ! ,� CITY OF CARMEL, INDIANA VENDOR: 370236 �� ONE CIVIC SQUARE CONSTRUCTION SPECIALTIES, INC CHECK AMOUNT: $••******88.00' ;9 �; CARMEL, INDIANA 46032 PO BOX 415278 CHECK NUMBER: 254084 "�di6w"c�. BOSTON MA 02241-5278 CHECK DATE: 02/05/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1093 4235000 A236001863 88.00 BUILDING MATERIAL Construction Specialties, Inc. Remit to: P.O. Box 415278 iSpecialties' Construction Boston, MA 02241-5278 USA Credit Dept Phone: 570-546-5941 INVOICE www.c-sgroup.com Customer# Invoice Number I Invoice Date= Reprint Date C EIVED 179735 A2 36001863 1115116 Invoice To: 179735tp To: 179735 JAN 2t1 CARMEL CLAY S&PARKRECATION REC U CLAY PARKS 1411 EAST 116TH'STREET MC -WEST . Wy CARMEL, IN 46032 USA — --- CENTRAL PARK DRIVE EAST CARMEL,IN 46032 USA 317-573-4026' Customer PO# Date'Rec'd _P,rojectName; 3211 01/15/16 CARMEL CLAY PARKS =_.Order.#- OaWShip lied>, _.. rPrd Num Terms` 219174 01/15/16 663328526359 1 965071 NET 30 'Shipped Via n Tax�Exe'mpt No. °_ FREIGHT ALLOWED°TO JOB SITE FEDEX GROUND SERVICE F.O.B.SHIPPING POINT p y pped Unit Price Line,Total- Item Description Qt �Shi SM20N CORNER GUARD 8' COVER/GALVESTON GRAY 2.000 EA ACTUAL COVER HEIGHT NO DEDUC TIONS FREIGHT SURCHARGE 1.000 EA Sub Total 88.00 �aax 6.1 Total 94.16 .Tax Summary IN STATE TAX 6.16 PO#3211 Although our re resentative is 361 WILLIAM BAKER COMPANY Pay Last Amount g P in this Column Please make payment to: Construction Specialties,Inc.' (USD)US Dollars PLEASE RETURN REMITTANCE COPY WITH PAYMENT TO THE ABOVE ADDRESS Terms and Conditions Agreements are conditional upon fires,strikes and other causes beyond our control. Our responsibility ceases when items hereon are delivered to transportation company in good condition. No goods may be returned nor will we accept back charges unless authorized by this office in writing prior to your action. IMPORTANT: All past due accounts are subject to the following service charge which shall commence on the due date of any Installment or Installments.The Imposition of the service charge shall in no way be deemed to be a waiver by Construction Specialties,Inc of it's option to declare the entire balance due and payable at any time. The service charge shall be the lesser of(A)two percent(2%)per month(24%per annum)or(B)the maximum lawful rate of interest permitted under the laws of the State of New Jersey.All Invoices referred for collection will be subject to additional.charges to buyer which buyer shall be obligated to pay including, but not limited to,the cost of any legal actions and reasonable attorney's fees thereon. DECO REAUTTANCE COPY Page 1 of 1 Farm ST-105 Indiana Department of Revenue State Norm 49065 11418.05 General Sales Tax Exemption Certificate Indiana registered:retail merchants and businesses located outside Indiana may use this certificate,The rimmed exemption must be allowed by Indiana code. Bxemplion`stattrtes of other states.are not valid#lir purchases from Indiana vendors.This exemption cerilficate.can,not be issuer/for the purchase of. C't"s;Y 1 cl c, WaLejX or Aircraft, Purchaser must be registered with the Department of Revenue or the appropriate taxing authority of the purchaser's state of residence, Sales tax must be charged unless BU informatiom.in each section is fully completed'by the purchaser.Purchasers not able to provide all required information must pay the tax and may file a claim for refund(Form CA-)1 OL)directly with the Department of Revenue. Name or Purchaser Cartnel;Clay Parks&Recreation Business Address.1411 E. 116th StreetCity Carmel state IN Zip 46032 a? Purchaser must provide minimum of one ID number'below.* 441 Provide yourindiana Registered Retail Merchant's Certificate M ` 01196830$3 _ 001 - TID and LOC Number aS,shown on your Certificate,............... M- TIU#El0 digits}. LOCt#f 3"digits) If not registered with the Indiana DOR provide your State Tax <' ID Number front another State................................:................................ *See instructions on the reverse side if you do hot have either number. State tD# State of issue Is this a m blanket purchase exemption request or a Cl single purchase exemption request? (check one) ' Description of items to be purchased_ Purchaser-must indicate the type of exemption being claimed for this purchase. (check one or explain) ❑ Sales to a retailer,wholesaler,or manufacturer for resale only. 0 Sale of manufacturing machinery,tools,and equipment to be used directly in direct production. Cl Sates to nonprofit organizations claiming exemption pursuant to Sales Tax Information Bulletin#10. (May not be used for personal hotel rooms and rzieaIs;) ?y .0 Sales of tangible personal property predominately used(greater then 56percent)in providing public transportation-provide USDOT#. t!r; A person or corporation-who is hauling under someone else's motor carrier authority,or hash contractns a school-bus-operator,must o; provide their SS#,orFID#in lieu of a Stale ID#it)Section#I. USDOT# 0 Sates to persons,occupationally engoged as farmers,to be used directly in production of agricultural products for sale. Note:A,farmer not possessing a.3late Business License#may'enter a FID#or a SS#in lieu of a Stale.ID#in Section#l. C) Sales to a contractor for exempt projects(such as public s0fools,government,or nonprofits). ® Sales to Indiana Governmental Units(agencies,cities,towns,municipalities,public schools,and state universities). M,Sales todhe United States.Federal Government;-show agency name. Note;A U.S.Government agency should enter its Federal Identi fieation.Number(FID#)in Section#1 in lieu of a State IDN: ;i pie'= C3 Other=explain. 1 hereby certify under the pe allies that the property purchased by the use of this exemption cerlific ate is tit be used fur an exempt purpose pursuarit to the State Gross''Retail Sales Tax Act,Indiana Code 6.15;and the iteempurchased is not a utility,vehicle,watercraft,oraircraft. ]-confirm illy understanding t misuse,(0-flier-negligent or intentional),andlor fraudulent use of this certificate may subject both me personally Q and/or the business entity I ;pr sent to he imposition of tax,interest,and civil and/or crun)nal penalties. ?' Signature of Purchaser Date t't3"1S Printed Nani. Mark Westermeier "I",tic Director The Indiana Department of:Revenuc may request verification or registration in another state if.you are an out-of-statc purchaser. Seiler must keep this certificate onfile to support exempt sales. ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. Construction Specialties, Inc. Terms P.O. Box 415278 Boston, MA 02241-5278 Invoice Invoice Description Date Number (or note attached invoice(s)or bill(s)) PO# Amount 1/15/16 A236001863 Additional Replacement Corner Guards xx3211 $ 88.00 Total $ 88.00 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 f Voucher No. Warrant No. Construction Specialties, Inc. Allowed 20 P.O. Box 415278 i Boston, MA 02241-5278 In Sum of$ r $ 88.00 4 I ON ACCOUNT OF APPROPRIATION FOR i 109 -Monon Center PO#or INVOICE NO. ACCT#/TITL AMOUNT Board Members Dept# 1093 A236001863 4235000 $ 88.00 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 madewere ordered and received except January 27, 2016 Signature $ 88.00 4 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund