HomeMy WebLinkAbout200636 08/17/2011 CITY OF CARMEL, INDIANA VENDOR: 363840 Page 1 of 1
ONE CIVIC SQUARE STATE SAFETY COMPLIANCE LLC
i CHECK AMOUNT: $72.36
CARMEL, INDIANA 46032 5338 VICTORY DRIVE STE A
INDIANAPOLIS IN 46203 CHECK NUMBER: 200636
CHECK DATE: 8/17/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9829695 72.36 OTHER EXPENSES
INVOICE
State Safety Compliance, LLC.
INVOICE
Branch: 701 Indianapolis 9829695
5338 Victory Dr Invoice Date Page
Suite A 8/2/2011 15:34:11 1 of 1
Indianapolis, IN 46203 ORDER NUMBER
3573043
317 423 -7724
Bill To: Ship To:
City of Carmel Utilities City of Carmel Utilities
Wastewater Carmel W.W.T.P (JEFF COOPER 8 -2 -11)
760 Third Ave. SW, Suite 110 9609 Hazel Dell Parkway
Carmel, IN 46032 Indianapolis, In 46280
09095
PO Number Terms Description Net Due Date Disc Due Date Discount Amount
JEFF COOPER 8 -2 -11 0.5% 10 net 30 09/01/11 08/12/11 0.31
Order Date Pick Ticket No Primary Salesrep Name Taker
81212011 10:21 :18 5834488 Gary Collins JCHANEY
Quantities Pricing
Item ID UOM Unit Extended
Ordered Shipped Remaining UOM 4 Item Description Unit Size Price Price
Unit Size 9
Delivery Instructions: UPS GROUND PREPAY ADD
.Carrier: UPS Ground -PPA _s Tracking I Z203YOA0355591522-
2.0000 2.0000 0.0000 DZ SG 1345 -L DZ 23.6818 47.36
12.0 GLOVES LEATHER RR 2.5 CUFF 6 DZ /CS 12
3/4 LEATHER BACK STRIPE FABRIC BACK
2.5" RUBBERIZED CUFF LINED PALM (6
DZ /CASE)
3.0000 3.0000 0.0000 DZ J9 DZ 4.9101 14.73
12.0 GLOVES BROWN JERSEY MENS 9 OZ LARGE 12
(25!DZ PER CS.)
Total Lines. 2 SUB- TOTAL: 62.09
Total Freight In: 0.00 Total Freight Out: 10.27 TOTAL FREIGHT. 10.27
TAX: 0.00
AMOUNT DUE: 72.36
1
ORIGINAL
VOUCHER 115646 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
9829695 01- 7202 -05 $72.36
Voucher Total $72.36
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 8/8/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/8/2011 9829695 $7236
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