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Home My WebLink About331829 10/30/18 `% � F� CITY OF CARMEL, INDIANA VENDOR: 363840 �• ONE CIVIC SQUARE STATE SAFETY&COMPLIANCE LLC CHECK AMOUNT: $*****1,070.67* 9� �`�,, CARMEL, INDIANA 46032 5358 VICTORY DRIVE STE A CHECK NUMBER: 331829 .y,�TON�, INDIANAPOLIS IN 46203 CHECK DATE: 10/30/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 10652786 1,070.67 OTHER EXPENSES VOUCHER NO. 186737 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995) Vendor # 363840 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER STATE SAFETY&COMPLIANCE LLC CITY OF CARMEL 5358 VICTORY DRIVE STE A An invoice or bill to be properly itemized must show: kind of service,where performed, INDIANAPOLIS, IN 46203 dates service rendered, by whom, rates per day, number of hours, rate per hour, numbers of units, price per unit, etc. Payee $1,070.67 363840 Purchase Order No. ON ACCOUNT OF APPROPRATION FOR STATE SAFETY&COMPLIANCE LLC Terms Carmel Wasterwater Utility 5358 VICTORY DRIVE STE A Due Date BOARD MEMBERS I hereby certify that that attached invoice INDIANAPOLIS,IN 46203 (s), or bill(s)is(are)true and correct and that PO# ACCT# the materials or services itemized thereon DATE INVOICE# Description DEPT# INVOICE# Fund# AMOUNT for which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 10652786 01-7200-02 $1,070.67 and received except 10/24/2018 10652786 $1,070.67 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. 20_ Clerk-Treasurer STATE;SAFETY&COMPLIANCE. Branch: 701 Indianapolis INVOICE 5358 Victory Dr INVOICE 1 Indianapolis,IN 46203 10652786 Invoice Date Page 10/17/2018 10:22:49 I __---1 of I--- 317-423-7724 _-—- __ORDER NUMBER — 4161113 J "DIRECT SHIPMENT" Bill To: Ship To: Carmel Waste Water Treatment Carmel Waste Water Treatment Attn:Paul Arnone Carmel W.W.T.Attn: DUANE JARVIS 9609 Hazel Dell Parkway 9609 Hazel Dell Parkway Indianapolis,IN 46280 Indianapolis,In 46280 Ordered By: Erika Davenport — _Customer ID.:_._1-09095 PO Number Term Description Net Due Date Disc Due Date DiscountAmount S18915 0.5% 10 net 30 11/16/2018 10/27/2018 4.65 Order Date Pick Ticket No Primary Salesrep Name Taker 9/21/2018 14:44:03 6661584 Gary Smith EDAVENPORT Quantities Pricing Item ID UOM Unit Extended Ordered Skipped Remaining UOM Item Description Price Price Unit Size p Unit Size Delivery Instructions: UPS GROUND-PPA Frt Cd OUT Carrier: UPS Ground Tracking#: 523304434 50.00 50.00 0.00 EA 03-500-IOS CWWTP STENCIL EA 18.6000 930.00 1.0 CONE 28" ORANGE W/4 & 6' RFLCTV 7# 1.0000 BASE STENCIL: CWWTP STENCILED. IN BLACK ALONG BOTTOM EDGE OF CONE Total Lines: I SUB-TOTAL: 930.00 Total Freight ba: 0.00 Total Freight Out: 110.67 TOTAL FREIGHT: 140.67 -— -- — — --- -- — -- — —— - -- —- -TAX: 0:00 — AMOUNTDUE.- 1,070.67 Received by • Date: ID-o-?V-J „ PO #: 519 9 1 S cct #: O 1 .-7 a©o, o 9, Use: 5a4- C ©Nes Specials and MTO items are non-cancellable,non-returnable,and subject to ~10% over/under shipment per manufacturer regulations. No returns accepted without RMA number. ORIGINAL 12.17.2242-11/12/15