HomeMy WebLinkAbout259478 06/14/16 / ,• CITY OF CARMEL, INDIANA VENDOR: 369232
® ONE CIVIC SQUARE BLACKMORE& BUCKNER ROOFING LLCCHECK AMOUNT: $"•`.17,675.00'
:p ?� CARMEL, INDIANA 46032 1504 SADLIER CIRCLE SOUTH DRIVE CHECK NUMBER: 259478
Maio , INDIANAPOLIS IN 46239 CHECK DATE: 06/14/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1206 R4350900 32571 SI12902 17,675.00 REFLECTING POOL REPAI
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995)
BLACKMORE& BUCKNER ROOFING LLC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
IN SUM OF$ CITY OF CARMEL
1504 SADLIER CIRCLE SOUTH DRIVE
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
INDIANAPOLIS, IN 46239 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$17,675.00 Payee
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Street Department Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
32571 S112902 43-509.00 $17,675.00 1 hereby certify that the attached invoice(s),or 5/26/16 S112902 $17,675.00
1206 Encumbered 101 1206 101
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Tuesday, May 31,2016
a
Street CO
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
20
Cost distribution ledger classification if claim paid motor vehicle highway fund.
Clerk-Treasurer
BILACKMORE • INVOICE
A I EETAAMERIEA COMPANY
Blackmore & Buckner Roofing, LLC Invoice Number: S112902
1504 Sadlier Circle South Drive a Phone: 317-263-0707 Invoice Date: 05/26/16
Indianapolis, IN 46239 . Fax: Due Date 06/15/16
www.blackmorebuckner.com Page No: 1
Bill Ship )
To: CARMEL STREET DEPARTMENT To: Carmel City Center
3400 W 131 ST STREET Mr.David Huffman
CARMEL, 46074 762 3rd Ave
United States Carmel, 46074
United States
Ship Via Customer ID CAR135
Ship Date 05/26/16 Customer P.O. 32571
Terms Net 20 Salesperson
Job Description: Invoice S112902 Project No. 14205
Item/Description Unit Order Qty Quantity Unit Price Total Price
TOWER ROOF REPAIRS 0.5 0.5 35,350.00 17,675.00
AT THE REFLECTING POOL
YOUR PO#32571 DTD 11/13/15
Subtotal: 17,675.00
Amount Subject to Amount Exempt Invoice Discount: 0.00
Sales Tax from Sales Tax Tax: 0.00
0.00 17,675.00
Total: 17,675.00
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 attomeys'fees incurred due to nonpayment.
INDIANA RETAIL TAX EXEMPT Page 1 of 9
City
of
Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 32571
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,AIP
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
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
11/13/2015 369232 Tower Roof Repairs at the Reflecting Pool
BLACKMORE&BUCKNER ROOFING LLC Street Department
VENDOR 1504 SADLIER CIRCLE SOUTH DRIVE SHIP 3400 W. 131st Street
TO Carmel,IN 46074-
INDIANAPOLIS,IN 46239- (317)733-2001
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department. 1206 Account: 43-509.00 Fund: 101 General Fund
1 Each Repairs-Reflecting Pool $35,350.00 $35,350.00
Sub Total $35,350.00
Send Invoice To:
Street Department
3400 W. 131st Street
Carmel, IN 46074-
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECTACCOUNT AMOUNT
PAYMENT $35,350.00
SHIPPING INSTRUCTIONS -AIP 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
'SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
`C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
`PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS.
'THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO, ORDERED B
ITLE Dire
DOCUMENT CONTROL NO. 32571 CLERK-TREASURER