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HomeMy WebLinkAbout258967 05/31/16 %'�' F• CITY OF CARMEL, INDIANA VENDOR: 364677 �• ONE CIVIC SQUARE CLEAN EARTH SYSTEMS INC CHECK AMOUNT: $*****4,490.00* '� ,�� CARMEL, INDIANA 46032 15245 AMBERLY DRIVE CHECK NUMBER: 258967 z„iTON�. TAMPA FL 33647 CHECK DATE: 05/31/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 70875 4,490.00 OTHER EXPENSES VOUCHER # 165344 WARRANT# ALLOWED 364677 IN SUM OF $ CLEAN EARTH SYSTEMS INC 15245 AMBERLY DRIVE TAMPA, FL 33647 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 70875 01-720H-08 $4,490.00 Voucher Total $4,490.00 Cost distribution ledger classification if claim paid under 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 364677 CLEAN EARTH SYSTEMS INC Purchase Order No. 15245 AMBERLY DRIVE Terms TAMPA, FL 33647 Due Date 5/16/2016 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 5/16/2016 70875 $4,490.00 hereby certify that the attached invoice(s), or bill(s) is (are)true and :orrect and I have audited same in accordance with IC 5-1.1-10-1.6 Date Officer 'A - Voice: (813) 930-6688 in VOICE Fax: (813) 930-2530 Invoice Number: C 8 a aid 70875 s000ao©©oeaeo.a.....:a x s�e.r..,;,:.:.::.I Invoice Date: S Y S T F IV1 `•3, I N C. 15245 AMEERLY DRIVE Apr 12, 2016 Tampa, FL 33647-2155 Page: USA Sold To: Ship to: City of Carmel HHW9 City of Carmel HHW 760 3rd Avenue 901 N Rangeline Road Attn. Bill Kelam Carmel, IN 46032 Carmel, IN 46032 _ Customer ID _Customer PO Payment Terms _ CITY0019 BKellam040816 2% 15, Net 30 Days _ Sales Rep ID Shipping Method Ship Date Due Date_ MW - _ -'H ROB - _ 4/8/16 5/12/16 Quantity Item Description Unit Price Extension 80.000HTW100 •C' H 11G Triple-Wall Haz Box 34.00 2,720.00 80.00 HUMIL �CH Liner 6-mil 20/Roll 16Roll/Pallet i 50.00 D-30GOHPR AD 30G OH Poly Recon 25.00 1,250.00 i I i I Subtotal 3,970.00 Sales Tax Freight 520.00 Total Invoice Amount 4,490.00 Check/Credit Memo No Payment/Credit Applied TOTAL 4,490.00