HomeMy WebLinkAbout188531 08/03/2010DEPARTMENT
651
651
651
CITY OF CARMEL, INDIANA
ONE CIVIC SQUARE
CARMEL, INDIANA 46032
5023990
5023990
5023990
VENDOR: 363840
STATE SAFETY COMPLIANCE LLC
5338 VICTORY DRIVE STE A
INDIANAPOLIS IN 46203
ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
9727828
9727857
9729264
Page 1 of 1
CHECK AMOUNT: $316.39
CHECK NUMBER: 188531
CHECK DATE: 8!312010
103.65 OTHER EXPENSES
163.74 OTHER EXPENSES
49.00 OTHER EXPENSES
PO Number
Terms Description
Net Due Date
Disc Due Date
Discount Amount
S12212
0.5% 10 net 30
08/20/10
07/31/10
0.46
Order Date
Pick Ticket No
Primary Salesrep Name
Taker
7/13/2010 09:48:16
5732170
Gary Collins
JCHANEY
Quantities
Item ID
Item Description
Pricing
UOM
Unit Si
Unit
Price
Extended
Price
Ordered
Shipped
Remaining
UOM
Unit Size
•dsi p
State Safety Compliance, LLC.
Branch: 701 Indianapolis
5338 Victory Dr
Suite A
Indianapolis, IN 46203
317- 423 -7724
Bill To:
City of Carmel Utilities
Wastewater
760 Third Ave. SW, Suite 110
Carmel, IN 46032
Cu torner ID: 109095
Delivery Instructions: UPS GROUND PREPAY ADD
Carrier: UPS Ground PPA Tracking
10.0000 10.0000 0.0000 EA
2.0000 2.0000 0.0000 BX
Total Lines: 2
Total Freight lri: 0.00
ORIGINAL
UB613B
1.0 DOO HAT BLUE (12 /PK)
Total Freight Out: 1 0:83
Ship To:
City of Carmel Utilities
Carmel W.W.T.P (PO S12212)
9609 Hazel Dell Parkway
Indianapolis, In 46280
INVOICE
9727828
Invoice Date
7/21/2010 09:39:36
Page
1 of 1
ORDER NUMBER
3509723
EA
3M8511 BX
10.0 MASK N95 RESP. W /VALVE (10 /BX -8 BX. /CS)
1
10
*DIRECT SHIPMENT
5.5000
18.9100
SUB- TOTAL:
TOTAL FREIGHT:
TAX:
AMOUNT DUE:
INVOICE
55.00
37.82
92.82
10.83
0.00
103.65
PO Number
Terms Description
Net Due Date
Disc Due Date
Discount Amount
S12212
0.5% 10 net 30
08/20/10
07/31/10
0.78
Order Date
Pick Ticket No
Primary Salesrep Name
Taker
7/13/2010 09:48:16
5732208
Gary Collins
JCHANEY
Quantities
Item ID
/tent Description
Pricing
UOM
Size
Unit
Price
Price
Extended
Price
Ordered
Shipped
Remaining
UOM
Unit Size
•dsia
State Safety Compliance, LLC.
Branch: 701 Indianapolis
5338 Victory Dr
Suite A
Indianapolis, IN 46203
317 -423 -7724
Bill To:
City of Carmel Utilities
Wastewater
760 Third Ave. SW, Suite 110
Carmel, IN 46032
Customer ID: 109095
Delivery Instructions: UPS GROUND PREPAY ADD
Carrier: UPS Ground AAA Tracking 1ZR6V3210344223401
2.0000 2.0000 0.0000 EA RASV46G -L EA
1.0 VEST GREEN 5PT BREAKAWAY CLASS 2
ZIPPER, 2 TONE TRIM; 2 VERTICAL 1
HORIZONTAL REFLECTIVE STRIP; HOOK
LOOP BREAKAWAY AT SHOULDERS,
SIDES ZIPPER; 7 POCKETS
5.0000 5.0000 0.0000 EA
5.0000 5.0000 0.0000 EA
1.0000 1.0000 0.0000 EA
ORIGINAL
Ship To:
City of Carmel Utilities
Cannel W.W.T.P (PO S12212)
9609 Hazel Dell Parkway
Indianapolis, In 46280
RASV46G -XL EA
1.0 VEST GREEN 5PT BREAKAWAY CLASS 2
ZIPPER, 2 TONE TRIM; 2 VERTICAL I
HORIZONTAL REFLECTIVE STRIP; HOOK
LOOP BREAKAWAY AT SHOULDERS,
SIDES ZIPPER; 7 POCKETS
RASV46G -2XL
1.0 VEST GREEN 5PT BREAKAWAY CLASS 2
ZIPPER, 2 TONE TRIM; 2 VERTICAL I
HORIZONTAL REFLECTIVE STRIP; HOOK
LOOP BREAKAWAY AT SHOULDERS,
SIDES ZIPPER; 7 POCKETS
RASV46G -3XL
1.0 VEST GREEN 5PT BREAKAWAY CLASS 2
ZIPPER, 2 TONE TRIM; 2 VERTICAL I
HORIZONTAL REFLECTIVE STRIP; HOOK
LOOP BREAKAWAY AT SHOULDERS,
SIDES ZIPPER; 7 POCKETS
INVOICE
INVOICE
9727857
Invoice Date
7/21/2010 10:02:47
Page
1 of2
ORDER NUMBER
3509723
EA
EA
1
*DIRECT SHIPMENT
12.0000
12.0000
12.0000
12.0000
24.00
60.00
60.00
12.00
INVOICE
9727857
Invoice Date
Page
7/21/2010 10:02:47
2 of 2
ORDER NUMBER
3509723
State Safety Compliance, LLC.
Branch: 701 Indianapolis
5338 Victory Dr
Suite A
Indianapolis, IN 46203
317 423 -7724
Total Lines: 4
Total Freight In: 0.00
Total Freight Out: 7.74
INVOICE
SUB TOTAL: 156.00
TOTAL FREIGHT: 7.74
TAX: 0.00
AMOUNT DUE: 163.74
VOUCHER 105933 WARRANT ALLOWED
363840
STATE SAFETY COMPLIANCE LLC
5338 VICTORY DRIVE STE A
INDIANAPOLIS, IN 46203
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
PO INV ACCT AMOUNT Audit Trail Code
9727857 01- 7202 -06 5156.00
9727857 01- 7202 -06 57.74
COI 3.�
q 47$a I. 72O2,06
Voucher Total
X01
Cost distribution ledger classification if
claim paid under vehicle highway fund
IN SUM OF
Board members
Prescribed by State Board of Accounts
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
5338 VICTORY DRIVE STE A
INDIANAPOLIS, IN 46203
Purchase Order No.
Terms
Due Date
City Form No. 201 (Rev 1995),
7/28/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/28/2010 9727857 $163.74
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
D ate
Officer
PO Number
Terms Description
Net Due Date
Disc Due Date
Discount Amount
S12212
0.5% 10 net 30
08/26/10
08/06/10
0.21
Order Date
Pick Ticket No
Primary Salesrep Name
Taker
7/13/2010 09:48:16
5733527
Gary Collins
JCHANEY
Quantities
Item ID
Item Description
Pricing
UOM
Unit Size
Unit
Price
Extended
Price
Ordered
Shipped
Remaining
UOM
Unit Size
•dsiq I
State Safety Compliance, LLC.
Branch: 701 Indianapolis
5338 Victory Dr
Suite A
Indianapolis, IN 46203
317 -423 -7724
Bill To:
City of Carmel. Utilities
Wastewater
760 Third Ave. SW, Suite 110
Carmel, IN 46032
Customer ID: 109095
Delivery Instructions: UPS GROUND PREPAY ADD
Carrier: uPS Ground PPA Tracking 1Z203Y0A0352572325
12.0000 12.0000 0.0000 PR
Total Lines: I
Total Freight In.0.00
ORIGINAL
Total Freight Out: 7.00
Ship To:
City of Carmel Utilities
Carmel W.W.T.P (PO S12212)
9609 Hazel Dell Parkway
Indianapolis, In 46280
INVOICE
9729264
Invoice Date
7/27/2010 13:56:23
Page
1 of 1
ORDER NUMBER
3509723
PYSB6170S PR
I.0 GLASSES SILVER MRR/BLK SURVEYOR 12 /BX 1
3.5000
SUB TOTAL:
TOTAL FREIGHT:
TAX:
AMOUNT DUE:
INVOICE
42.00
42.00
7.00
0.00
49.00
VOUCHER 105945 WARRANT ALLOWED
363840
STATE SAFETY COMPLIANCE LLC
5338 VICTORY DRIVE STE A
INDIANAPOLIS, IN 46203
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
PO INV ACCT AMOUNT Audit Trail Code
9729264 01- 7202 -06 $42.00
9729264 01- 7202 -06 $7.00
Voucher Total $49.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
IN SUM OF
Board members
Prescribed by State Board of Accounts
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
5338 VICTORY DRIVE STE A
INDIANAPOLIS, IN 46203
Purchase Order No.
Terms
Due Date
City Form No. 201 (Rev 19957
7/30/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/30/2010 9729264 $49.00
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
Date
Officer