HomeMy WebLinkAbout197399 05/11/2011 CITY OF CARMEL, INDIANA VENDOR: 363840 Page 1 of 1
ONE CIVIC SQUARE STATE SAFETY COMPLIANCE LLC CHECK AMOUNT: $284.44
s; 4� CARMEL, INDIANA 46032 5336 VICTORY DRIVE STE A
INDIANAPOLIS IN 462D3 CHECK NUMBER: 197399
CHECK DATE: 5/11/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9802734 148.23 OTHER EXPENSES
651 5023990 9803680 85.82 OTHER EXPENSES
651 5023990 9804931 50.39 OTHER EXPENSES
INVOICE
State Safety Compliance, LLC.
INVOICE
Branch: 701 Indianapolis 9804931
5338 Victory Dr Invoice Date Page
Suite A 5/4/2011 13:53:52 1 1 of 1
Indianapolis, IN 46203 ORDER NUMBER
3556680
317- 423 -7724
Bill To: Ship To:
City of Carmel Utilities City of Carmel Utilities
Wastewater Carmel W.W.T.P (PO St2476)
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
512476 0.5% 10 net 30 06/03/11 05/14/11 0.21
Order Date Pick Ticket No Primary Salesrep Name Taker
4/29/2011 09:41:40 5809571 Gary Collins JCHANEY
Quantities Pricing
Item ID UOM Unit Extended
Ordered Stripped Remaining UOM Ttem Description Unit Size Price Price
Unit size O
Delivery Instructions: UPS GROUND PREPAY ADD
Carrier: UPS Ground PPA Tracking 1 Z203YOA0351243236
1.0000 1.0000 0.0000 BX UAA031 11101 BX 42.3900 42.39
1.0 EARPLUG CLASSIC CORDED POLY BAG 200PR /BX 1
NRR29
Total Lines: I SUBTOTAL: 42.39
Total Freight In: 0.00 Total Freight Out: 8.00 TOTAL FREIGHT. 8.00
TAX: 0.00
AMOUNT DUE: 50.39
ORIGINAL
VOUCHER 115072 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
9804931 01- 7202 -06 $50.39
Voucher Total $50.39
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 5/9/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
519/2011 9804931 $50.39
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
INVOICE
State Safety Compliance, LLC.
INVOICE
Branch: 701 Indianapolis 9802734
5338 Victory Dr Invoice Date Page
Suite A 4/27/2011 08:35:51 1 of 1
Indianapolis, IN 46203 ORDER NUMBER
3555052
-7724
317- 423
Bill 23 Ship To: "DIRECT SHIPMENT"
City of Carmel Utilities City of Carmel Utilities
Wastewater Carmel W.W.T.P (C /O JEFF COOPER)
760 Third Ave. SW, Suite 110 9609 Hazel Del] Parkway
Carmel, IN 46032 Indianapolis, In 46280
C tisterner ID: 109095
PO Number Terms Description Net Due Date Disc Due Date FDiscount Amount
JEFF COOPER 4 -20 -11 0.5% 10 net 30 05/27/11 05/07/11 0.40
Order Date Pick Ticket No Primary Salesrep Name Taker
4/20/2011 15:18:26 5807461 Gary Collins JCHANEY
Quantities Pricin
S
Item ID UOM Unit Extended
Ordered Shipped Renmining UOM 4 Item Description Unit Si a Price Price
Unit Size C
Delivery Instructions: UPS RED PREPAY &ADD PER JEFF COOPER
Carrier: UPS Red PPA Tracking IZ09X9240105016929
3.0000 3.0000 0.0000 EA OCC- LUX300 -L (LIME) EA 7.6900 23.07
1.0 SHIRT HI -VIS LIME LARGE COTTON 1
3.0000 3.0000 0.0000 EA OCC- LUX300 -XL (LIME) EA 7.6900 23.07
1.0 SHIRT HI -VIS LIME XL COTTON 1
3.0000 3.0000 0.0000 EA OCC- LUX300 -2XL (LIME) EA 8.4625 25.39
.1.0 SHIRT HI -VIS LIME 2XL COTTON 1
1.0000 1.0000 0.0000 EA OCC- LUX300 -3XL (LIME) EA 9.2300 9.23
1.0 SHIRT HI -VIS LIME 3XL COTTON I
Total Lines: 4 SUB- TOTAL: 80.76
Total Freight In: 0.00 Total Freight Out: 67.47 TOTAL FREIGHT: 67.47
TAX: 0.00
AMOUNT DUE: 148.23
ORIGINAL
INVOICE
State Safety Compliance, LLC.
INVOICE
Branch: 701 Indianapolis 9803680
5338 Victory Dr Invoice Date Page
Suite A 4/29/2011 15:33:51 1 of 1
Indianapolis, IN 46203 ORDER NUMBER
3556680
317- 423 -7724
Bill To: Ship To:
City of Carmel Utilities City of Carmel Utilities
Wastewater Carmel W.W.T.P (PO S12476)
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
S12476 0.5% 10 net 30 05/29/11 05/09/11 0.36
Order Date Pick Ticket No Primary Salesrep Name Taker
4/29/2011 09:41:40 5808421 Gary Collins JCHANEY
Quantities Pricing
Item ID UOM Unit Extended
Ordered Shipped Remaining UOM 4 Item Description Unit Size Price Price
Unit She 2
Delivery Instructions: UPS GROUND PREPAY ADD
Currier: UPS Ground PPA Tracking IZ203YOA0351239241
2.0000 2.0000 0.0000 EA A29R -WHITE EA 7.3800 14.76
1.0 HARD HAT WHITE RTCHT 4PT W/O RAIN TROUGH 1
USES NRCP5005 BRACKET AND
NRAO152 /40 FACE SHIELD
24.0000 24.0000 0.0000 PR S2510S PR 1.3833 33.20
1.0 GLASSES CLEAR LENS WRAP- AROUND ZTEK 1213X1
2.0000 2.0000 0.0000 BX 3M8210 BX 11.9300 23.86
20.0 RESPIRATOR DUST DISP.(20 /BOX -8 /CASE) 20
DUST MASK, DISPOSABLE
Total Lines: 3 SUB- TOTAL: 71.82
Total Freight ln: 0.00 Total Freight Out: 14.00 TOTAL FREIGHT. 14.00
TAX. 0.00
AMOUNT DUE: 85.82
ORIGINAL
VOUCHER 115038 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
9802734 01- 7202 -06 $14823
-6
Voucher Total ,$149-23'
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 5!212011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/2/2011 9802734 $148.23
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