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