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HomeMy WebLinkAbout204557 12/13/2011 CITY OF CARMEL, INDIANA VENDOR: 365148 Page 1 of 1 ONE CIVIC SQUARE GALLOWAY GROUP CARMEL, INDIANA 46032 5840 YOUNGQUIST RD CHECK AMOUNT: $2,279.34 FT MEYERS FL 33912 CHECK NUMBER: 204557 CHECK DATE: 12/13/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1115 4350000 27681 24954 2,279.34 CONCRETE HANDHOLE THE GALLOWAY GROUP, INC. 5840 YOUNGQUIST RD. Q FORT MYERS, FL 33912 PH. 239 481 -7448 FAX 239 481 -7445 800- 481 -7448 11/29/2011 24954 BILL TO: SHIP TO: City of Carmel, IN City of Carmel Terry Crockett 31 1st Ave N W Three Civic Square Carmel, IN. 46032 Carmel, IN 46032 317 -571 -2586 @)Op J 27681 Net 30 WC 1 1/28/2011 Galloway -Indy y7 IF maw 2 IN/NB173018 17x30x18 polymer concrete assembly,w /20K cover. 229.67 459.34 4 IN/NB243624 24x36x24 Polymer concrete assembly, w /20K cover, EMS 455.00 1,820.00 marker. Thank you! Ohio Office 614 -414 -0861 Sr/lf1 $2,279.34 LCf SAR GU"RD,. LITHO USA SFMS 20018 (R 4/94) 08/11 L05SF000733M Cit INDIANA RETAIL TAX EXEMPT PAGE Ca rmel CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 35- 60000972 6f ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE. 'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 6 Calloway group SHIP Carmel Communication Center VENDOR TO 31 1 st Ave MW 2571 F erris Road Carmel, IN 46032 A A CONFIRMATION BLANKET CbNTRACT PAYMENT TERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 43. 500.00 2 Each 17x30x18 Polymer concrete Handhole $229.67 $459.34 4 Each 24x3&24 Polymer Concrete Handhole $455.00 $1,820.00 Sub Total: $2,279.34 0°C' a� Send Invoice To: c Carmel Communication Center 39 1 st Ave NW Carmel, IN 46032- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT PAYMENT n� Communications A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNL �1w i7 NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY I PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. Dire CLERK TREASURER DOCUMENT CONTROL NO. 2760 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO. WARRANT NO. ALLOWED 20 IN THE SUM OF ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I 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 20 Signature Title Cost distribution ledger classification if claim paid motor 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 11/29/11 24954 $2,279.34 1 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 N W ARRANT NO. ALLOWED 20 Galloway Group IN SUM OF 2571 Ferris Road Columbus, OH 43224 $2,279.34 ON ACCOUNT OF APPROPRIATION FOR Carmel Clay Communications PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members 27681 I 24954 I 43- 500.00 I $2,279.34 I 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 Monday, December 12, 2011 Dire ctor Title Cost distribution ledger classification if claim paid motor vehicle highway fund