311889 05/30/17 `� ���"f CITY OF CARMEL, INDIANA VENDOR: 363840
ONE CIVIC SQUARE STATE SAFETY & COMPLIANCE LLC CHECK AMOUNT: $.......190.12*
r CARMEL, INDIANA 46032 5338 VICTORY DRIVE STE A CHECK NUMBER: 311889
+•,Tory gb INDIANAPOLIS IN 46203 CHECK DATE: 05/30/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 10486839 190.12 OTHER EXPENSES
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State Safety & Compliance, LLC. INVOICE
Branch: 701 Indianapolis
5358 Victory Dr INVOICE
Indianapolis, IN 46203 10486839
Invoice Date Page
317-423-7724
4/28/2017 13:09:00 1 of 1
---
ORDER NUMBER
Bill To: 4032790
Carmel Waste Water Treatment "DIRECT SHIPMENT"
Attn: Paul Arnone Ship To:
9609 Hazel Dell Parkway Carmel Waste Water Treatment
Indianapolis, IN 46280 Attn.: Duane Jarvis(PO: S 17083)
9609 Hazel Dell Parkway
Indianapolis, In 46280
Customer ID: 109095
PO Number Terms Description Net Due Date Disc Due Date Discount Amount
S17083 0.5% 10 net 30 5/28/2017 5/8/2017 0.86
Order Date Pick Ticket No Primary Salesrep Name Taker
4/4/2017 16:42:55 6493732 Gary Smith PGENDRON
Quantities Pricing
Item ID mic Unit Extended
Ordered Shi ed Remainin UOM 4 Item Description Price Price
pP g Unit Size C Unit Size
Order Note: FREIGHT CHARGES ESTIMATED AT $65.00
FOR THIS ORDER--THIS IS ONLY AN
ESTIMATE.THE CHARGES MAY BE LOWER
OR HIGHER DUE TO WEIGHT OF PRODUCT
AND SHIPPING METHOD, PJG
Carrier: UPS Ground- PPA Tracking#:IZ09X9240345145783
1.0000 1.0000 0.0000 EA OCC-LUX-TJBJ-2XL EA 57.2700 57.27
1.0 JACKET BOMBER YLW CL 3; RFLTV STRIPES 1.0000
1.0000 1.0000 0.0000 EA OCC-LUX-TJBJ-L EA 57.2700 57.27
1.0 JACKET BOMBER YLW CL 3; RFLTV STRIPES 1.0000
100% ANSI POLYESTER W/ PU COATING;
WATERPROOF; REMOVABLE FLEECE
LINER- JACKET SLEEVES; ZIPPER& SNAP
CLOSER
1.0000 1.0000 0.0000 EA OCC-LUX-TJBJ-XL EA 57.2700 57.27
1.0 JACKET BOMBER YLW CL 3; RFLTV STRIPES 1.0000
Total Lines:3 SUB-TOTAL: 171.81
Total Freight In:0.00 Total Freight Out:18.31 TOTAL FREIGHT. 18.31
TAX. 0.00
AMOUNT DUE: 190.12
U.S. Dollars
ORIGINAL