HomeMy WebLinkAbout189008 08/18/2010 CITY OF CARMEL, INDIANA VENDOR: 363840 Page 1 of 1
D ONE CIVIC SQUARE STATE SAFETY COMPLIANCE LLC CHECK AMOUNT: $36.78
s io CARMEL, INDIANA 46032 5338 VICTORY DRIVE STE A
INDIANAPOLIS IN 46203 CHECK NUMBER: 189008
CHECK DATE: 8/18/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9730028 36.78 OTHER EXPENSES
INVOICE
State Safety Compliance, LLC.
INVOICE
Branch: 701 Indianapolis 9730028
5338 Victory Dr Invoice Date Page
Suite A 7/30/2010 09:06:55 1 of I
Indianapolis, IN 46203 ORDER NUMBER
3504073
3t7 -423 -7724
Bill To: Ship To: *DIRECT SHIPMENT
City of Carmel Utilities City of Carmel Utilities
Wastewater Carmel W.W.T.P (PO S12188)
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 Disc Due Date Discount Amount
S12188 0.5% 10 net 30 08/29/10 08/09/10 0.15
Order Date Pick Ticket No Primary Salesrep Name Taker
6/7/201.0 13:04:18 5734433 Gary Collins JCHANEY
Quantities Pricing
Item ID UOM Unit Extended
yi Item Description Price Price
Ordered Shipped Remaining UONI Unit Size
Unit She p
Delivery Instructions: UPS GROUND PREPAY ADD
Carrier: UPS Ground PPA Tracking IZ4782120359966189
1.0000 1.0000 0.0000 DZ WCHV0500 -L DZ 30.1200 30.12
1.0 GLOVES Hl -VIZ COWHIDE PREMIUM 6DZ /CS 1
RUBBERIZED SAFETY CUFF; 2 STRIPES OF
REFLECTIVE TAPE... WING THUMB
Total Lines: 1 SUB- TOTAL: -30.12
Total Freight M. 0.00 Total Freight Out: 6.66 TOTAL FREIGHT: 6.66
TAX. 0.00
AMOUNT DUE: 36.78
ORIGINAL
VOUCHER 105991 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
9730028 01- 7202 -05 $36.78
Voucher Total $36.78
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 8/9/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/9/2010 9730028 $36.78
1 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
i
Date Officer