HomeMy WebLinkAbout195212 03/02/2011 CITY OF CARMEL, INDIANA VENDOR: 363840 Page 1 of 1
ONE CIVIC SQUARE STATE SAFETY COMPLIANCE LLC CHECK AMOUNT: $139.80
CARMEL, INDIANA 46032 5338 VICTORY DRIVE STE A
INDIANAPOLIS IN 46203
CHECK NUMBER: 195212
CHECK DATE: 3/2/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9781255 139.80 OTHER EXPENSES
INVOICE
State Safety Compliance, LLC.
INVOICE
Branch: 701 Indianapolis 9781255
5338 Victory Dr Invoice Date Page
Suite A 2/14/2 14:33: 1 of 1
Indianapolis, IN 46203 ORDER NUMBER
3541309
317- 423 -7724
Bill To: Ship To:
City of Carmel Utilities City of Carmel Utilities
Wastewater Carmel W.W.T.P (PO S12398)
760 Third Ave. SW, Suite 110 9609 Flazel Dell Parkway
Carmel, IN 46032 Indianapolis, In 46280
Customer Ill: 109095
PO Number Terns Description Net Due Date Disc Due Date Discount Anjount
512398 0.5% 10 net 30 03/16/11 02/24/11 0.64
Order Date Pick Ticket No Primary Salesrep Name Taker
2/3/2011 12:53:18 5785634 Gary Collins JCHANEY
Quantities Pricing
Item ID U041 Unit Extended
Ordered Stripped llenrairring UOM 4 Item Description Unit Size Price Price
Unit Size O
Delivery Instructions: UPS GROUND PREPAY ADD
Carrier: UPS Ground PPA Tracking IZ203YOA0352145108
4.0000 4.0000 0.0000 DZ J9 DZ 4.0000 16.00
12.0 GLOVES BROWN JERSEY MENS 9 OZ LARGE 12
(25 /DZ PER CS.)
4.0000 4.0000 0.0000 EA RIV2003 -XL EA 8.2000 32.80
1.0 RAINSUIT CLASSIC .35MM 3 PIECE PVC 1
JACKET W/ DETACHABLE HOOD BIB
PANTS
2.0000 2.0000 0.0000 13: NRTS1005 BX 40.0000 80.00
1.0 GLASSES CLEAR /BLK REBEL (12 /BOX)
REBEL SAFETY GLASSES BLACK
TEMPLE /CLEAR LENS 12 /BOX -12 BX /CS
(144 PR)
Total Lines: 3 SUB- TOTAL: 128.80
Total Freight In. 0.00 Total Freight Out: N.00 TOTAL FREIGHT: 11.00
TAX: 0.00
AMOUNT DUE: 139.80
ORIGINAL
VOUCHER 107145 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
9781255 01- 7202 -06 $139.80
Voucher Total $139.80
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form fro. 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 2/22/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/22/2011 9781255 $139.80
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