HomeMy WebLinkAbout193432 01/05/2011 CITY OF CARMEL, INDIANA VENDOR: 364475 Page 1 of 1
ONE CIVIC SQUARE GSSI GROUP, INC.
L•- 0 CHECK AMOUNT: $4,815.00
CARMEL, INDIANA 46032 7510 NALLIAMSBURG DRIVE
CUMMINGGA 30041 CHECK NUMBER: 193432
CHECK DATE: 1/5/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1115 4350100 07110 1,107.00 BUILDING REPAIRS MA
1115 R4350100 27549 07110 3,708.00 LIGHTS /WIRING KIT
GSSI Group, Inc. Invoice
7510 Williamsburg Dr.
Cumming, GA 30041 Date Invoice
12/20/2010 07110
Bill To Ship To
City of Carmel Same
Carmel Communications Center
31 1 st Ave., NW
Carmel, IN 46032
P.O. Number Terms Rep Ship Via F.O.B. Project
27549 Net 30 VS /CS 12/20/2010
Quantity Item Code Description Price Each Amount
90 T8K -4 -192 T -8 type, 4 foot LED Tube light, 192 LED's, 18 Watts, 1350 53.50 4,815.00
Lumens, 120 volt, Pure White
Total $4,815.00
Carmel INDIANA RETAIL TAX EXEMPT PAGE
C i t CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 27549
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
12114120`1
OSSI Groups Carmel Communication Center
VENDOR
SHIP 39 1st Ave NW
7690 Williamsburg Drive To Carmel, IN 46032
Cumming, GA 30041 (317) 371 -2686
CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43- 509.00
3 Each LED tube lights T8- 4 -MR120 $1,164.00 $3,492.00
3 Each Wiring kit for LED lights TM -Kit $72.00 $216.00
Sub Total: $3,708.00
Al
FL_.
�J U U I
Send Invoice To:
Carmel Commun Center
31 9 st Ave NW
Carmel, IN 46032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Communications PAYMENT $3,708.00
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL
SHIPPING �2L
THIS ORDER R ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE rte
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
Q CLERK TREASURER
DOCUMENT CONTROL NO. 6 J A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO.— WARRANT NO.
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
20
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
GSSI Group
IN SUM OF
7510 Williamsburg Drive
Cumming, GA 30041
$4,815.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Clay Communications
PO# Dept. INVOICE N0. ACCT /TITLE AMOUNT Board Members
Prior Year Encumbered I hereby certify that the attached invoice(s), or
27549 07110 43 501.00 $4,815.00
bills) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Thursday, December 30, 2010
Director
Title
Cost distribution ledger classification if
claim paid motor 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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/27/10 07110 $4,815.00
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
20
Clerk- Treasurer