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
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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