HomeMy WebLinkAbout196558 04/13/2011 CITY OF CARMEL, INDIANA VENDOR: 363840 Page 1 of 1
ONE CIVIC SQUARE STATE SAFETY COMPLIANCE LLC CHECK AMOUNT: $240.75
ti•,�ro CARMEL, INDIANA 46032 5338 VICTORY DRIVE STE A
INDIANAPOLIS IN 46203 CHECK NUMBER: 196558
CHECK DATE: 4/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9794362 240.75 OTHER EXPENSES
INVOI
State Safety Compliance, LLC.
INVOICE
Branch: 701 Indianapolis 9794362
5338 Victory Dr Invoice Date Page
Suite A 3/30/201 t 10:33:33 1 of 1
Indianapolis, IN 46203 ORDER NUMBER
3550085
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
Custurner ID: 109095
PO Number Terms Description Net Due Date Disc Due Date Discount Amount
JEFF COOPER 3 -24 -11 0.5% 10 net 30 04/29/11 04/09/11 1.20
Order Date Pick Ticket No Primary Salesrep Name Taker
3/24/2011 14:55:49 5798870 Gary Collins JCHANEY
Quantities Pricing
Item ID OOM Unit Extended
Ordered Shipped Remaining UOM a Item Description Unit Size Price Prue
Unit Size C
Delivery Instructions: GARY WILL DELIVER... 431 -6983
Carrier: Please Deliver Tracking gary -2 del
2.0000 2.0000 0.0000 DZ J9 DZ 4.0000 8.00
12.0 GLOVES BROWN JERSEY MENS 9 OZ LARGE 12
(25 /DZ PER CS.)
3.0000 3.0000 0.0000 BT 6644 BT .33.1077 99.32
1.0 EARPLUG SPARKPLUG DISPENSER (200 /BTL) 1
PLUGSTATION 250 PAIRS SPARKPLUGS
(WITHMOUNTING BRACKET) DISPENSER
1.0000 1.0000 0.0000 CS TY127SWH002500 -2XL CS 133.4286 133.43
I.0 COVERALL TYVEK ZPR ELS WRS /ANK HD (25 /C) 1
Total Lines: 3 SUB- TOTAL: 240.75
TAX: 0.00
AMOUNT DUE: 240.75
ORIGINAL
VOUCHER 107471 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
9794362 01- 7202 -06 $240.75
Voucher Total $240.75
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 241 (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 4/6/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/6/2011 9794362 $240.75
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