HomeMy WebLinkAbout198273 06/06/2011 CITY OF CARMEL, INDIANA VENDOR: 363840 Page 1 of 1
ONE CIVIC SQUARE STATE SAFETY COMPLIANCE LLC
h CHECK AMOUNT: $41.42
CARMEL, INDIANA 46032 5338 VICTORY DRIVE STE A
INDIANAPOLIS IN 46203 CHECK NUMBER: 198273
CHECK DATE: 6/6/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9806274 41.42 MATERIALS SUPPLIES
INVOICE
State Safety Compliance, LLC.
INVOICE
Branch: 701 Indianapolis 9806274
5338 Victory Dr Invoice Date Page
Suite A 5/9/2011 15:00:36 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
512476 0.5% 10 net 30 06/08/11 05/19/11 0.17
Order Date Pick Ticket No Primary Salesrep Name Taker
4/29/2011 09:41:40 5810925 Gary Collins JCHANEY
Quantities UOM Pricing
Item ID Unit Extended
Ordered Shipped Remaining UOM Item Description Unit Size Price Price
Unit Size O
Delivery Instructions: UPS GROUND PREPAY ADD
Carrier: UPS Ground PPA Tracking IZ203YOA0352593482
3.0000 3.0000 0.0000 EA E2RW7IA000 EA 11.1400 33.42
1.0 HARD HAT BLUE RTCHT 8PT SUSPENSION 1
FIBRE METAL; CLASS E, G, C, TYPE 1
Total Lines: I SUB- TOTAL: 33.42
Total Frei In: 0. Total F_r_e_ight Out•8_00 TOTAL FREI _8.00_
TAX. 0.00
AMOUNT DUE: 41.42
ORIGINAL
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 6/2/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/2/2011 9806274 $41.42
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
VOUCHER 115197 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
9806274 01- 7202 -06 $41.42
Voucher Total $41.42
Cost distribution ledger classification if
claim paid under vehicle highway fund