HomeMy WebLinkAbout253215 01/11/16 %'�,q,,f� CITY OF CARMEL, INDIANA VENDOR: 363840
® \I ONE CIVIC SQUARE STATE SAFETY &COMPLIANCE LLC CHECK AMOUNT: $*******295.11
9 �� CARMEL, INDIANA 46032 5338 VICTORY DRIVE STE A CHECK NUMBER: 253215
y��roN�°. INDIANAPOLIS IN 46203 CHECK DATE: 01/11/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 10329022 295.11 OTHER EXPENSES
INVOICE
State Safety & Compliance, LLC. INVOICE
Branch: 701 Indianapolis 10329022
5358 Victory Dr Invoice Date Page
Indianapolis,IN 46203 12/8/2015 15:58:431 1 of 1
ORDER NUMBER
3918486
317-423-7724
Bill To: Ship To: **DIRECT SHIPMENT**
Carmel Waste Water Treatment Carmel Waste Water Treatment Plant
Attn: Paul Arnone Attn.: Duane Jarvis(po: S15627)
9609 Hazel Dell Parkway 9609 Hazel Dell Parkway
Indianapolis,IN 46280 Indianapolis,In 46280
Customer ID: 109095
PO Number Terms Description Net Due Date Disc Due Date Discount Amount
S15627 0.5% 10 net 30 01/07/16 12/18/15 1.37
Order Date Pick Ticket No Primary Sa[esrep Name Taker
11/24/2015 16:37:35 6334977 Gary Smith PGENDRON
Quantities Pricing
Item ID UOM Unit Extended
Ordered Shipped Remaining UOMT" �
Item Description Unit Size Price Price
Ut S
Carrier: UPS Ground-PPA Tracking#:1 Z09X9240370762907
3.0000 3.0000 0.0000 EA OCC-LUX-TJBJ-2XL EA 54.9400 164.82
1.0 JACKET BOMBER YLW CL 3; RFLTV STRIPES 1
1.0000 1.0000 0.0000 EA OCC-LUX-TJBJ-3XL EA 54.9400 54.94
1.0 JACKET BOMBER YLW CL 3;RFLTV STRIPES 1
1.0000 1.0000 0.0000 EA OCC-LUX-TJBJ-L EA 54.9400 54.94
1.0 JACKET BOMBER YLW CL 3;RFLTV STRIPES 1
100% ANSI POLYESTER W/ PU COATING;
WATERPROOF;—.REMO_V_ABLE.---.FrLEECE- -- ---- -- -. - ------
LINER-JACKET SLEEVES; ZIPPER& SNAP
CLOSER
Total Lines:3 SUB-TOTAL: 274.70
Total Freight In:0.00 Total Freight Out:20.41 TOTAL FREIGHT. 20.41
TAX. 0.00
AMOUNT DUE: 295.11
ORIGINAL
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 12/17/2015
Invoice . Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/17/201; 10329022 $295.11
hereby certify that the attached invoice(s), or bill(s) is(are)true and
:orrect and I have audited same in accordance with IC 5-11-10-1.6
Date Officer Officer
t .
VOUCHER # 156874 . WARRANT # ALLOWED
363840 IN SUM OF $
STATE SAFETY & COMPLIANCE LLC i
5338 VICTORY DRIVE STE A i.
INDIANAPOLIS, IN 46203
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR y
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
10329022 01-7200-01 $109.88
10329022 01-7202-06 $185.23
_ 1
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Voucher Total $295.11
Cost distribution ledger classification if
claim paid under vehicle highway fund