HomeMy WebLinkAbout195661 03/16/2011 a CITY OF CARMEL, INDIANA VENDOR: 363840 Page 1 of 1
0 ONE CIVIC SQUARE STATE SAFETY COMPLIANCE LLC CHECK AMOUNT: $59.60
CARMEL, INDIANA 46032 5338 VICTORY DRIVE STE A
y oN GO INDIANAPOLIS IN 46203 CHECK NUMBER: 195661
CHECK DATE: 311612011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9786768 59.60 OTHER EXPENSES
INVOICE
State Safety Compliance, LLC. INVOICE
Branch: 701 Indianapolis 9786768
5338 Victory Dr Invoice Date Page
Suite A 3/3/2011 15:59:45 1 of 1
Indianapolis, IN 46203 O RDER NU MBER
35461
317- 423 -7724
Bill To: Ship To:
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
Customer ID: 109095
PO Number Terms Description Net Due Date Disc Due Date Discount Amount
JEFF COOPER 3/3/11 0.5% 10 net 30 04/02/11 03/13/11 0.30
Order Date Pick Ticket No Primary Salesrep Name Taker
3/3/2011 08:51:05 5791120 Gary Collins JCHANEY
Quantities Pricing
Item ID U019 Unit Extended
Ordered Slipped Remaining UOM y Item Description Unit Size Price Price
Unit Size Q
Delivery Instructions: GARY WILL PICK UP TOMORROW AND
DELIVER
Carrier: Please Deliver Trucking gary 2 del
1.0000 1.0000 0.0000 BG SSOO BG 31.1000 31.10
1.0 PAD OIL 15X18 (M -WH) WHITE (100 /BL) 1
(E100) (30 BALES /PALLET)
1.0000 1.0000 0.0000 BG SSOWB BG 28.5000 28.50
1.0 PAD OIL /WATER 15X18 GRAY BGM (100 /13G) 1
(36 BALES /PALLET)
Total Liiies: 2 SUB- TOTAL 59.60
TAX: 0.00
AMOUNT DUE: 59.60
ORIGINAL
VOUCHER 107284 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
9786768 01- 7202 -06 $59.60
Voucher Total $59.60
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 3/8/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/8/2011 9786768 $59.60
I
i
hereby certify that the attached invoice(s), or bill(s) is (are) true and
;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer