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164719 10/16/2008
CITY OF CARMEL, INDIANA VENDOR: 00353338 Page 1 of 1 ONE CIVIC SQUARE GEMPLER'S INC CARMEL, INDIANA 46032 Po Box 5176 CHECK AMOUNT: $173.60 JANESVILLE WI 53547 -5176 CHECK NUMBER: 164719 CHECK DATE: 1011612008 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4237000 1012129782 173.60`REPAIR PARTS c is e a ,YP ..A gy m" P4 g,' Nis x'A nhre Order 13y Phone: 1- 800 -382 -8473 Gemplers (AIMPLEIrS Order Online: www Ge 1 r 39-17 26218 Order By Fax: 1- 800 551 -1128 -1128 GS 1'# 8940974 4097476R'I' 1125 Deming Way PO Box 44993 J ��A� Madison WI U.S.A 53717 Madison, W I USA 53744-4993". 'i SEP 17 20 t 001302 PAGE 1 OF 1 8 CARMEL CLAY PARRS RECREATION S CARMEL CLAY PARRS RECREATION ACCOUNTS PAYABLE 1427 E 116TH ST 1427 E 116TH ST P. CARMEL IN 46032 -3455 T! CARMEL IN 46032 -3455 Ti Oi der:: M13o P.4, 11f© Sold T a fVo ln�rflice fVa. Inv.0 ce Date Due Date 111111- SCO3728549 SCELAEGEL09102008 6260182 3 1012129782 09/11/2008 10/11/2008 E3uyer Carrier 5 la. '€arms::: .10 bate Payment 'Teerrts SCHLAEGEL,COURTNEY UPSGND LOCKED 09/11/2008 Net 30 WY QTY UNIT LINE PRQt7UCT NQ ICE MPTtC3N B:Q �HlP; U M :,.:AMOUNT AMf�IJNT 1 106235 HOSE REEL WALL MNT 16 INX20. 0 1.00 EA 88.60 88.60 2 0064234 -1 BCKPCK SPRYR REPL HOSE /45IN 0 1.00 EA 8.95 8.95 3 4074337 SPRYR REPL SOLO SCREW CAP 0 1.00 EA 2.95 2.95 4 490017ON SPRYR SHUTOFF VLV WAND N 0 1.00 EA 31.25 31.25 5 4900527 SPRYR REPL SOLO PLAS ADJ NOZ 0 4.00 EA 6.25 25.00 A RTV'F, D Purchase L S E P fl 9 2008 Description t (W�. t C e P.O. P or cat a Budget SUBTOTAL: 156.75 Thank you for your order. Line Descr FREIGHT: 16.85 Purchaser Date TAXES: 0.00 Approval D q -G PAYMENT TERMS: Net 30 TOTAL AMOUNT DUE BY 10/11/2008 173.60 USD ORIGINAL After 94 days from invoice date, Lab Safety Supply, Inc. will not be responsible to show proof of delivery. TITLE TO ALL MERCHANDISE SHIPPED PASSES TO THE PURCHASER UPON DELIVERY TL THE COMMON CARRIER. NO CLAIMS, DEDUCTIONS OR RETURNS ACCEPTED WITHOUT OUR WRITTEN CONSENT. ALL CLAIMS MUST BE MADE WITHIN 15 DAYS AFTER RECEIPT OF GOODS. ALL PRICES SUBJECT TO CHANGE WITHOUT NOTICE; PRICES PREVAILING ON TIME OF DELIVERY. THE GOODS COVERED BY THIS INVOICE WERE PRODUCED IN COMPLIANCE WITH THE REQUIREMENTS OF THE FAIR LABOR STANDARDS ACT OF 1938, AS AMENDED. THESE COMMODITIES ARE LICENSED FOR THE ULTIMATE DESTINATION SHOWN. DIVERSION CONTRARY TO THE UNITED STATES LAW IS PROHIBITED. CUSTOMER HEREBY UNCONDITIONALLY AND WITHOUT RESERVATION AGREES THAT LAB SAFETY SUPPLY, INC. IS ENTITLED TO ENFORCE THE TERMS OF THIS SHIPPING ORDER UNDER THE LAWS OF THE STATE OF WISCONSIN AND IN A WISCONSIN FORUM. r c� ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Gempler's Purchase Order No. 00353338 Acct 6260182 Terms P.O. Box 5176 Janesville, WI 53547 -5176 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/11/08 1012129782 Repair parts for sprayer's hose reel 173.60 i Total 173.60 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 20_ Clerk- Treasurer Voucher No. Warrant No. Gempler's 00353338 Acct 6260182 Allowed 20 P.O. Box 5176 Janesville, WI 53547 -5176 In Sum of 173.60 ON ACCOUNT OF APPROPRIATION FOR 101 General Fund PO# or INVOICE NO. kCCT #1TITLI AMOUNT Board Members Dept 1125 1012129782 4237000 173.60 1 hereby certify that the attached invoice(s), or bill(s) is (are) true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 1 -Oct 2008 Signature 173.60 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund