HomeMy WebLinkAbout201426 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 363840 Page 1 of 1
i. ONE CIVIC SQUARE STATE SAFETY COMPLIANCE LLC CHECK AMOUNT: $107.03
CARMEL, INDIANA 46032 5338 VICTORY DRIVE STE A
INDIANAPOLIS IN 46203 CHECK NUMBER: 201426
CHECK DATE: 9/13/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9839079 107.03 OTHER EXPENSES
INVOICE
State Safety Compliance, LLC. INVOICE
Branch: 701 Indianapolis 9839079
5338 Victory Dr Invoice Date Page
Suite, A 9/2/2011 15:07:30 1 Of I
Indianapolis, IN 46203 ORDER NUMBER
3578082
317 -423 -7724 �f
Bill To: Ship To:
City of Carmel Utilities City of Carmel Utilities
Wastewater Carmel W.W.T.P (JEFF COOPER 8- 29 -11)
760 Third Ave. SW, Suite 110 9609 Hazel Dell Parkway
Carmel, IN 46032 Indianapolis, In 46280
Customer l): 090, 0 5
PO Number Terms Description Net Due Date Disc Due Date FDiscount Amount
JEFF COOPER 8 -29 -11 0.5% 10 net 30 10/02/11 09/12/11 0.50
Order Date Pick Ticket No Primaty Salesrep Name Taker
8/29/2011 08:10:28 5844087 Gary Collins JCHANEY
Quantities Pricing
Item ID UOM Unit Extended
UOM 4 Item Description Price Price
Ordered Shipped Remaining Unit Size
Unit Size O
Delivery Instructions: UPS GROUND PREPAY ADD
Carrier: UPS Ground PPA Tracking IZ203YOA0355906227
8.0000 8.0000 0.0000 EA GU- GI540BA EA 12.4400 99.52
1.0 EYEWASH 8OZ ADDITIVE BACTERIOSTATIC I
GUARDIAN
Total Lines: I SUB- TOTAL: 99.52
Total Freight fir 0.00 Total Freight Out: 7.51 TOTAL FREIGHT: 7.51
TAX: 0.00
AMOUNT DUE: 107.03
ORI GIM L
VOUCHER 115798 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
9839079 01- 7202 -05 $107.03
Voucher Total $107.03
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 9/7/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/7/2011 9839079 $107.03
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance wit IC 5- 11- 10 -1.6
A ,__I 00-
Date Officer