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HomeMy WebLinkAbout188066 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 363840 Page 1 of 1 ONE CIVIC SQUARE STATE SAFETY COMPLIANCE LLC CARMEL, INDIANA 46032 5338 VICTORY DRIVE STE A CHECK AMOUNT: $99.52 'ti o ae INDIANAPOLIS IN 46203 CHECK NUMBER: 188066 CHECK DATE: 7/21/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 9723673 99.52 MATERIALS SUPPLIES INVOICE State Safety Compliance, LLC. INVOICE Branch: 701 Indianapolis 9723673 5338 Victory Dr Invoice Date Page Suite A 7/2/2010 14:25:58 1 of 1. Indianapolis, IN 46203 ORDER NUMBER 3504073 317- 423 -7724 Bill To: Ship To: City of Carmel Utilities City of Carmel Utilities Wastewater Carmel W.W.T.P (PO 512188) 760 Third Ave. SW, Suite 110 9609 Hazel Dell Parkway Carmel, IN 46032 Indianapolis, In 46280 Customer ID: 109095 PO Number Terms Description Net Due Date Dise Due Date Discount Amount 512188 0.5% 10 net 30 08 /01 /10 07/12/10 0.46 Order Date Pick Ticket No Primary Salesrep Name Taker 6/7/2010 13:04:18 5728027 Gary Collins JCHANEY Quantities Pricing Item ID UOM Unit Extended Ordered Shipped Remaining UOM 4 Item Description Unit Size Price Price Unit Size D Delivery Instructions: UPS GROUND PREPAY ADD Carrier: UPS Ground PPA Tracking IZ203YOA0351248142 24.0000 24.0000 0.0000 EA PYS2575S EA 1.9275 46.26 1.0 GLASSES BLUE MIRROR LNS /FRM ZTEK 12 /BX 1 24.0000 24.0000 0.0000 EA PYS2570S EA 1.9275 46.26 1.0 GLASSES SILVER MIRROR LNS /FRM ZTEK 12/13X 1 Total Lines: 2 SUB'- TOTALe 92.52 Total Freight In: 0.00 Total Freight Out: 7.00 TOTAL FREIGHT. 7.00 TAX: 0.00 AMO UNT D UE: 99.52 ORIGINAL VOUCHER 105814 WARRANT ALLOWED 363840 IN SUM OF STATE SAFETY COMPLIANCE LLC 5338 VICTORY DRIVE STE A INDIANAPOLIS, IN 46203 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 9723673 01- 7202 -06 $99.52 Voucher Total $99.52 Cost distribution ledger classification if claim paid under vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice or bill to be properly itemized must show, kind of service, where performed, dates of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 363840 STATE SAFETY COMPLIANCE LLC Purchase Order No. 5338 VICTORY DRIVE STE A Terms INDIANAPOLIS, IN 46203 Due Date 7/12/2010 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 7/12/2010 9723673 $99.52 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 7 G //o M Date Officer