HomeMy WebLinkAbout196089 03/29/2011 CITY OF CARMEL, INDIANA VENDOR: 276575 Page 1 of 1
ONE CIVIC SQUARE SAFETY SOLUTIONS, INC
CARMEL, INDIANA 46032 PO Box 6100
CHECK AMOUNT: $293.00
DUBLIN OH 46016 -2100
CHECK NUMBER: 196089
CHECK DATE: 3/29/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1885572 164.00 MATERIALS SUPPLIES
651 5023990 18886555 129.00 MATERIALS SUPPLIES
r A rrvv f �F 6183 Shamrock P.O Box 8100
Lublin, OH 43016-2100
Invoice, I 01885572
INCORPORATED 800232.7463 (fax )614,799 9901 a j I
Regional Offices 8, Distribution Centers
Page P 1
Birmingham, AL Columbus, OH Toledo, OH
866.241.9399 800.232.7463 449.380.9900 rocs
MAC 03/07/2011
Pittsburgh, PA Syracuse, NY Ft. Wayne, IN 7 �I t a� f �3
809.562.0555 800838.7463 250.444,2725
03/22/2011
Solif 129700 Ship To: 1
City Of Carmel City of Carmel
Water Distribution Sewer Department
3450 W 131st ST 760 3rd Ave. SW, Suite 110
Westfield, IN 46074 Carmel, IN 46032
Cus #omer PO Number �Refease No g,� Salesperson Wfise Ship Date Documen#
C;3 u.s'..
Verbai Aaron Jason Barzak 01 03707/201'1 `01571481
s a E
E E����
Terms "AT' Corte z €Frelgfit Shlp Via
Net 15 IN15 Prepaid Fedex Ground Intl Economy
i R^� �.I�z�
Item Numtier /Descrlptlon Ordered Shipped r Backorder M UM P,rlce Per' r Extension
4�H{ x P
0154784 1 1 0 PR 18.00 PR 18.00
4780 VISCOLAS ORTHEX INSOLES
MENS 11 -13
Note: for Darryl
0100000243950120 1 1 0 PR 108.00 PR 108.00
2439 WOLVERINE SZ: 12M
Aaron
01503012 2 2 0 PR 19.00 PR 38.00
030 MEGACOMFORT INSOLE SZ: 12
MENS SZ:12, WOMENS SZ: 14
Note: for Aaron
Remit To: Safety Solutions, Inc.
:4 btT a 3 s f
Merchandlse' ��S H t Payments �e Total Due
PO Box 8100 UU. 'V�. r e «E3
Dublin, OH 43016 -2100 164.00 0.00 0.00 164.00
fl_rrT!/ rn i irin �ll_ r 6161 Shamrock Ct.• P.O. Box 8100
Dublin, OH 43016 -2100 N
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S
tlnvotce 01886555
INCORPORATED 800.2327463•(iax)614.799.9901 a v'
Regional Offices Distribution Centers
�1 iPage x 1
Birmingham, AL Columbus, OH Toledo, OH
866.241.9399 800.2327463 419.380 9900
Q r�Date 03/08/2011
Pittsburgh, PA Syracuse, NY Ft. Wayne, IN
800.562.0555 800.836 -7463 260.444.2725 d
Due Date_ 03/23/2011
Sold To:' 129700 Ship To: 1
City Of Carmel
City of Carmel
Water Distribution Sewer Department
3450 W 131st ST 760 3rd Ave. SW, Suite 110
Westfield, IN 46074 Carmel, IN 46032
CustomerPO Number Release No Salesperson Whse �S Ship b Date Document
Jason_Barzaic__
Terms �TaxCode i Freight 1Sht I
3 L 1 'ni b E P fi f d
r Via r
Net 15 IN15 Prepaid Fedex Ground Intl Economy
i L i.ii8x 5 s& .!tw,� fir t�
ItemNurriber¢ Descri tlon� Ordered &hi ed Backorder lJM Pnce Per. 3 Extension
u�an 1 'teaAmMl. r �s�
m r 'v a P p e nZ
0100000669680130 1 1 0 PR 129.00 PR 129.00
6696 ROCKY SZ: 13W
Darryl
Shipping warehouse: 90
Remit To: Safety Solutions, Inc. �x E
Merchandise S H Tax Payments Total Due
POBox 8100��- .a, aTa�T.. ,cr. ,...._..E.��,�� 6'r•
Dublin, OH 43016 -2100 129.00 0.00 0.00 129.00
VOUCHER 107332 WARRANT ALLOWED
276575 IN SUM OF
SAFETY SOLUTIONS, INC
PO BOX 8100
DUBLIN, OH 46016 -2100
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
1886555 01- 7200 -01 $129.00
C 1 0
Voucher Total�'��
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
276575
SAFETY SOLUTIONS, INC Purchase Order No.
PO BOX 8100 Terms
DUBLIN, OH 46016 -2100 Due Date 3122/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/22/2011 1886555 $129.00
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
fq- 1—
Date Officer