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HomeMy WebLinkAbout320992 01/17/18 CITY OF CARMEL, INDIANA VENDOR: 371892 . d ?•: ONE CIVIC SQUARE ACS-INDY EAST CHECK AMOUNT: $*******100.55* d ,=a CARMEL, INDIANA 46032 3741 N SHADELAND AVE CHECK NUMBER: 320992 INDIANAPOLIS IN 46226 CHECK DATE: 01/17/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4236400 1450402 100.55 PAINT VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 371892 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER ACS-INDY EAST IN SUM OF$ CITY OF CARMEL 3741 N SHADELAN D AVE An invoice or bill to be properly itemized must show:kind of service,where performed,dates service rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. INDIANAPOLIS, IN 46226 Payee $100.55 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 1450402 42-364.00 $100.55 1 hereby certify that the attached invoice(s),or 1/11/18 1450402 $100.55 2201 2201 2201 2201 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,January 15,2018 Huffman, Dave 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. I Clerk-Treasurer 06 -ACS-Indy East INVOICE 3295 North Shadeland Avenue Indianapolis, IN 46226 P: (317)541-0221 F: (317)549-2057 Bill To: Ship To: Printed: 1/11/2018 9:47:16AM Carmel Street Department-3546 Same As Customer-3546 3400 W. 131 st St. Carmel, IN 46074 P: (317)733-2001 F: (317)733-2005 Technician: INVOICE INVOICE SLSM PURCHASE ORDER TAX ORDER COUNTER NUMBER DATE CODE NUMBER CODE TERMS NUMBER SHIP VIA CODE 1450402 1/11/2018 14 8 2% 10th, NET EOM 8 Delivery 99 -- H ITEM NUMBER ITEM DESCRIPTION T ORDERED SHIPPED UNIT NET TOTAL M X 771 OS/QT "Chromaseal"-"Valueshade" 1 1 QT 72.10 72.10 Sealer-#1 7775S/80Z "Chromabase""4-To-1" 1 1 801 28.45 28.45 Activator-70F-80F SUB TOTAL: 100.55 TOTAL DUE: 100.55 Signature: BALANCE DUE: 100.55 Emergency Response Contact:1(800)424-9300 CCN706033 1 HM Hazardous Material Description #Pks Unit Total W. X LIN 1263,Paint,3,PGIII LTD.QTY. 1 QT 3.1 �+ TOTAL 3.1 I i 1 1 J f Total Taxable: Total Due:$100.55 i For CHEMICAL EMERGENCY Spill Leak Fire Exposure or Accident call CHEMTREC day or night within USA and Canada:1-800-424-9300 CCN706033 or 1-703-527- 3887 collect calls accepted Page 1 of 1