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184490 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: 363781 Page 1 of 1 ONE CIVIC SQUARE SURFACE TEK CHECK AMOUNT: $7,136.50 i ro CARMEL, INDIANA 46032 115 S BROADWAY TECUMSEH OK 74873 CHECK NUMBER: 184490 CHECK DATE: 4/14/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4465000 22498 4996 7,136.50 SODA BLASTING EQUIP Invoice Date Invoice 3/29/2010 4996 1 15 S.-Broadway T c umseh, OKK 74 873 Phone: 405 -598 -0850 Fax: 405- 598 -0903 CA Contractors License www.surfacetekinc.com #904184 Bill To Ship To CARMEL CLAY PARRS AND RECREATION CARMEL CLAY PARKS AND RECREATION ATTN: SERRA GARSKIE ATTN: SIERRA GARSKE 1411 E. 116TH ST. 1427 E. 116TH ST. CARMEL, IN 46032 CARMEII IN 46032 P. O. Number Terms Due on receipt Quantity Description Price Each Amount 1 1.65 CU FT. ASME -CODE BLASTING POT 5,205.01 5,205.017 1 250CFMFM AFrERCOOLER 855.10 855.10T 1 400CFM WATER SEPARATOR 336.00 336.00T 1 DEADMAN SWITCH 129.42 129.42T 1 BLAST HOSE 50' 233.26 233.26T 1 AIR HOSE 50' 170.00 170.00T 1 AIR HOSE 5' 32.03 32.03T 50 POWER CORD 0.96 48.00T 1 #5 NOZZLE 181.00 181.00T 1 FUNNEL 84.40 84.40T DISCOUNT 789.22 789.22 ON LINE DISCOUNT 500.00 500.00 49 SODA EE 23.50 1,151.50T Purchase �CLb f�n. i� Description 01 1 i Yl�,PL`` o.L 0 I R- 4�4 W Q AP d 6 10 0 urair d'LLLIL D Purchaser Date Approval Date Made Payable inUSD Sales Tax (0.0 T o tal $7,136.50 Payments /Credits $0.00 Balance Due 7'1'36.50 1 ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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. Payee Purchase Order No. Surface Tek Terms 115 S Broadway Tecumseh, OK 74873 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amoun 3126110 4996 Soda blasting equipment 22498 7,136,50 Total 7,136.50 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_ Clerk- Treasurer Voucher No. Warrant No. Surface Tek Allowed 20 115 S Broadway Tecumseh, OK 74873 In Sum of 7,136.50 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. ACCT #fTITLE AMOUNT Board Members Dept 2249810, 4996 4465000 7,136.50 1 hereby certify that the attached invoice(s), or U 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 8 -Apr 2010 r Signature 7,136.50 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund