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HomeMy WebLinkAbout194257 02/03/2011 CITY OF CARMEL, INDIANA VENDOR: 179310 Page 1 of 1 ONE CIVIC SQUARE LAB SAFETY SUPPLY INC CHECK AMOUNT: $145.28 CARMEL, INDIANA 46032 PO BOX 5004 JANESVILLE WI 53547 -5004 CHECK NUMBER: 194257 CHECK DATE: 213/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 1016673408 145.28 MATERIALS SUPPLIES Order By Phone: 1- 800 356 -0783 Lab Safety Supply Order Online: www.LSS.com FEI 39- 1726218 Order By Fax: 1- 800 543 -9910 401 S. Wright Rd. Janesville WI U.S.A. 53547 -1368 LAB SAFETY SUPPLYM PO Box 1368 Janesville, WI USA 53547 -1368 001079 PAGE 1 OF 1 s CITY OF CARMEL S CITY OF CARMEL ACCOUNTS PAYABLE H I ATTN: CARMEL WATER DEPT L 5484 E 126TH ST P 5484 E 126TH ST T CARMEL IN 46033 -9289 7 CARMEL IN 46033 -9289 0 0 Order No. P.O. No. Sold To No. Invoice No. Invoice Date I Due Date SC07744857 BELL011111BELL 5208827 1 1016673408 01/11/2011 02/10/2011 Buyer Carrier Freight Terms Ship Date I Payment Terms BELL,WILLIAM UPSGND LOCKED 01/11/2011 Net 30 QTY. QTY. UNIT LINE PRODUCT NO. DESCRIPTION B. 0. SHIP U.O.M. AMOUNT AMOUNT 1 148988 -11 WRK SHOE STL -T GR 11 0 1 PR 66.70 66.70 2 148988 -10 WRK SHOE STL -T GR 10 0 1 PR 66.70 66.70 RECEArED MiL r J DATE PO# USA SUBTOTAL: 133.40 Thank you for your order. FREIGHT: 11.88 TAXES: 0.00 PN9434844982 ML PAYMENT TERMS: Net 30 TOTAL AMOUNT DUE BY 02/10/2011 145.28 USD These items are sold for domestic consumption in the United States. I£ exported, purchaser assumes full responsibility for compliance with US export controls. ORIGINAL After 90 days from invoice date, GHC Specialty Brands, LLC will not be responsible to show proof of delivery. TITLE TO ALL MERCHANDISE SHIPPED PASSES TO THE PURCHASER UPON DELIVERY TO THE COMMON CARRIER, NO CLAIMS, DEDUCTIONS OR RETURNS ACCEPTED WITHOUT OUR WRITTEN CONSENT. ALL CLAIMS MUST BE MADE WITHIN 15 DAYS AFTER RECEIPT OF GOODS. ALL PRICES SUBJECT TO CHANGE WITHOUT NOTICE: PRICES PREVAILING ON TIME OF DELIVERY. THE GOODS COVERED BY THIS INVOICE WERE PRODUCED IN COMPLIANCE WITH THE REQUIREMENTS OF THE FAIR LABOR STANDARDS ACT OF 1938 AS AMENDED. THESE COMMODITIES ARE LICENSED FOR THE ULTIMATE DESTINATION SHOWN. DIVERSION CONTRARY TO THE UNITED STATES LAW IS PROHIBITED. CUSTOMER HEREBY UNCONDITIONALLY AND WITHOUT RESERVATION AGREES THAT GHC SPECIALTY BRANDS, LLC IS ENTITLED TO ENFORCE THE TERMS OF THIS SHIPPING ORDER UNDER THE LAWS OF THE STATE OF ILLINOIS AND IN AN ILLINOIS FORUM. 3 VOUCHER 103909 WARRANT ALLOWED 179310 IN SUM OF LAB SAFETY SUPPLY ACCT 6078343 TM S PO BOX 5004 JANESVILLE, WI 53547 -5004 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR i Board members PO INV ACCT AMOUNT Audit Trail Code 1016673408 01- 6200 -03 $145.28 Voucher Total $145.28 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 179310 LAB SAFETY SUPPLY Purchase Order No. ACCT 6078343 Terms PO BOX 5004 Due Date 1/24/2011 JANE WI 53547 -5004 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1/24/2011 1016673408 $145.28 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