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HomeMy WebLinkAbout302134 08/22/16 CITY OF CARMEL, INDIANA VENDOR: 358385 .j; ® ,;• ONE CIVIC SQUARE GENERAL SHALE&BRICK CHECK AMOUNT: $*******450.00* CARMEL, INDIANA 46032 PO BOX 5825 CHECK NUMBER: 302134 CAROL STREAM IL 60197-5825 CHECK DATE: 08/22/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4236200 182511395 450.00 CEMENT VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) GENERAL SHALE & BRICK ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PO BOX 5825 IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service CAROL STREAM, IL 60197-5825 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $450.00 Payee ON ACCOUNT OF APPROPRIATION FOR Purchase Order# 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 182511395 42-362.00 $450.00 1 hereby certify that the attached invoice(s),or 8/8/16 182511395 $450.00 2201 201 2201 201 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 Monday,August 15,2016 Dave Huffman Director 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 0010 General Shale ''y::iV.:...:�CY:i?:i??iii:y ? %:`iii ;iilii::?:';Eiintiii>'%sit.i[i yjii`;%iit:`•i iiiiiii'ii?ii#5;3iii¢4:Yzi+?i2?ii`;i;?iir ::i i�i Invoice: 182511395 Invoice Date: 08/08/2016 Bill To: 279670 Customer PO: INLETS CITY OF CARMEL 3400 W 131ST STREET Bill of Lading: 172762805 WESTFIELD IN 46074-8267 Goods Issue Date: 08/08/2016 Order: 320789197 Sales Rep: 399 Ship-To: Job: CALLED IN BY RON Order Loc.: Carmel CITY OF CARMEL CARMEL IN 3400 W 131ST STREET Phone: 317-846-2566 WESTFIELD IN 46074-8267 Mode of Shipment: Customer -Pickup / 057 Material Material Description Quantity Price Value USD Batch Number and Description 6099001046 ESSROC BRIXMENT GRAY TYPE N 50 BAG 9.00 450.00 Subtotal 450.00 TAX TOTAL 450.00 LATE PAYMENT CHARGE of 1.5% PER MONTH. .Mx,:::: at ; ::::.:.::.::.::.:::.::.::.::.:>:......... .. ..::.::.:::.>:.>:.::::.::.::.::.: ,,.,,.,... .,,.............,,..,,.. Bill To: 279670 ,..,_.............. CITY OF CARMEL Bill of Lading: 172762805 3400 W 131ST STREET Date: 08/08/2016 WESTFIELD IN 46074-8267 Order Loc: Carmel CARMEL IN Sales Order: 320789197 Customer P0: INLETS Ship-To: Telephone: (317) 733-2001 Job: CALLED IN BY RON CITY OF CARMEL Shipper: GESH Carmel 3400 W 131ST STREET CARMEL IN WESTFIELD IN 46074-8267 Mode of Shipment: Customer Pickup 057 BRICK STCC 32 511 Directions: Material Description Order Quantity Weight Batch 6099001046 ESSROC BRIXMENT GRAY TYPE N 50 BAG 3,500.00 LB 1,590.91 KG TOTAL WEIGHT 3,500.00 LB 1,590.91 KG Drivers Name Driver License No. and State Trucking Company Dispatcher Name Phone No. DOT # Verified By