HomeMy WebLinkAbout201300 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 179310 Page 1 of 1
ONE CIVIC SQUARE LAB SAFETY SUPPLY INC
CARMEL, INDIANA 46032 Po Box 5004 CHECK AMOUNT: $449.44
JANESVILLE VVI 53547 -5004
�o CHECK NUMBER: 201300
CHECK DATE: 9/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1017791072 449.44 OTHER EXPENSES
Order By Phone: 1- 800 356 -0783 Lab Safety Supply
Order Online: www.LSS.com FEI 39- 1726218
Order By Fax: 1- 800 543 -9910 401 S. Wright Rd.
Janesville WI U.S.A. 53547 -1368
LAB SAFETY SUPPLY®
PO Box 1368
Janesville, WI USA 53547 -1368
001114 PAGE 1 OF 1
B CITY OF CARMEL s CITY OF CARMEL
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ACCOUNTS PAYABLE i 901 N RANGE LINE RD
L 760 3RD AVE SW P HOUSEHOLD HAZ WASTE
T CARMEL IN 46032 -2072 T CARMEL IN 46032 -1361
0 0
Order No. P.O. No. Sold To No. Invoice No. Invoice Date Due Date
SC08695530 KELLAM082311 520882? 1 1017791072 08/24/2011 09123/2011
Buyer Carrier Freight Terms Ship Date Payment Terms
KELLAM,BILL UPSGND3 LOCKED 08/23/2011 Net 30
QTY. QTY. UNIT
LINE PRODUCT NO. DESCRIPTION B.O. SHIP U.O.M. AMOUNT AMOUNT
1 2153 -2 PH PPR JUM RFLL 0 -13 PH PHYD 0 10 EA 10.90 109.00
2 135753L GLV EXAM POWERGRIP PWDR LATE 0 10 BX 12.80 128.00
3 52860 NTRLZR DRY. ACID SPILFYTER 0 1 EA 86.50 86.50
4 182899 HIGH TRAFFIC ROLL 15 X 150 F 0 1 EA 73.30 73.30
SUBTOTAL: 396.80
Thank you for your order. 'FREIGHT: 52.64
TAXES: 0.00
PN9618830948 ML
PAYMENT TERMS: Net 30 TOTAL AMOUNT DUE BY 09/23/2011 449.44 USD
These items are sold for domestic consumption in the United States. If exported, purchaser
assumes full responsibility for compliance with US export controls. ORIGINAL
After 90 days from invoice date, GHC Specialty Brands, LLC will not be responsible to show proof of delivery.
TITLE TO ALL MERCHANDISE SHIPPED PASSES TO THE PURCHASER UPON DELIVERY TO 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 GHC SPECIALTY BRANDS, LLC IS ENTITLED TO ENFORCE THE TERMS OF THIS SHIPPING ORDER UNDER THE LAWS
OF THE STATE OF ILLINOIS AND IN AN ILLINOIS FORUM.
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
179310
LAB SAFETY SUPPLY INC. Purchase Order No.
Acct 5208827 Terms
P.O. Box 5004 Due Date 9/7/2011
Janesville, WI 53547
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/7/2011 1017791072 $449.44
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
v/ A VA-�
Date Officer
VOUCHER 115795 WARRANT ALLOWED
179310 IN SUM OF
LAB SAFETY SUPPLY INC.
Acct 5208827
P.O. Box 5004
Janesville, WI 53547
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
1017791072 01- 720H -08 $449.44
Voucher Total $449.44
Cost distribution ledger classification if
claim paid under vehicle highway fund