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HomeMy WebLinkAbout190969 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 363840 Page 1 of 1 ONE CIVIC SQUARE STATE SAFETY COMPLIANCE LLC 0 CHECK AMOUNT: $100.18 CARMEL, INDIANA 46032 5338 VICTORY DRIVE STE A INDIANAPOLIS IN 46203 CHECK NUMBER: 190969 CHECK DATE: 10!1312010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 9742257 100.18 OTHER EXPENSES INVOICE State Safety Compliance, LLC. INVOICE Branch: 701 Indianapolis 9742257 5338 Victory Dr Invoice Date Page Suite A 9/17/2010 08:42:40 1 of 1 Indianapolis, IN 46203 ORDER NUMBER 3518791 317- 423 -7724 Bill To: Ship To: *DIRECT SHIPMENT" City of Carmel Utilities City of Carmel Utilities Wastewater Carmel W.W.T.P (JEFF COOPER) 760 Third. Ave. SW, Suite 110 9609 Hazel Dell Parkway Carmel, IN 46032 Indianapolis, In 46280 Custerner ID: 109095 PO Number Terms Description Net Due Date Disc Due Date Discount Amount JEFF COOPER 9.9. 10 0.5% 10 net 30 10/17/10 09/27/10 0.45 Order Date Pick Ticket No Primary Salesrep Name Taker 9/9/2010 10:05:50 5746718 Gary Collins JCHANEY Quantities Pricing Item ID UONt Unit Extended Ordered Shipped Rer»aining UOM 4 Item Description Unit Size Price Price Unit Size C Delivery Instructions: UPS GROUND PREPAY ADD GARY WILL TAKE THE COVERALLS Carrier: UPS Ground PPA Tracking l Z8294960383081254 3.0000 3.0000 0.0000 PR PIP57 -8675 PR 30.3300 90.99 1.0 GLOVES NEOPRENE 31" SMOOTH GRIP 1 GAUNTLET CUFF; BRUSHED INTERLOCK LINED; CHEMGRIP Total Lines: I SUB- TOTAL: 90.99 Total Freight In. 0.00 Total Freight Out: 9.19 TOTAL .FREIGHT. 9.19 TAX: 0.00 AMOUNT DUE: 100.18 1 ORIGINAL VOUCHER 106352 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 9742257 01- 7202 -06 $100.18 Voucher Total $100.18 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 10/5/2010 Invoice Invoice Description Date Number. (or note attached invoice(s) or bill(s)) Amount 10/5/2010 9742257 $100.18 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 ffi