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