HomeMy WebLinkAbout204757 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: 365720 Page 1 of 1
I. ONE CIVIC SQUARE COVITA CHECK AMOUNT: $53.16
CARMEL, INDIANA 46032 30 WASHINGTON AVE SUITE B
HODDONFIELDNJ 08033 CHECK NUMBER: 204757
CHECK DATE: 12/2012011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1201 4341980 25878 V1557 53.16 MOUTHPIECES
coVita Invoice
l 30 Washington Ave, Suite B
C O t a Haddonfield, NJ 08033 DATE INVOICE
tools for treatment professionals (800)707 -5751 10/21 /2011 V1557
service @covita.net TERMS DUE DATE
http://www.covita.net
Net 30 11/20/2011
BILL TO SHIP TO
City of Carmel City of Carmel
Attn: Jim Spelbring Attn: Jim Spelbring
One Civic Square 1 Civic Square
Carmel, IN 46032 Carmel, IN 46032 USA
AMOUNT DUE ENCLOSED
$53.16
T Please detach top portion and return with pour paytncnt. a
SHIP DATE SHIP VIA Customer P.O.
10/21/2011 UPS 3 -Day Select 25878
Item Description Quantity Rate Amount
FP -MP /250 Flatpak disposable cardboard mouthpieces, box of 1 35.00 35.00
250
864 8x6x4 Box 8x6x4 1 0.00 0.00
PURE COMPLIMENTARY Bedfont hand sanitizer 1 15.00 15.00
is alcohol -free Kills 99.99% of Germs, Bacteria,
Fungi
D
DEC 19 2011
By
Shipping Handling Charges (may include haz -mat). SUBTOTAL $50.00
NOTE: This invoice, and the contents of the shipment associated with it
will be presumed correct unless customer contacts us within 5 days of DISCOUNT (30
the receipt of the shipment. Please inspect your shipment immediately.
TAX (7 $0.00
SHIPPING $18.16
TOTAL $53.16
Federal Tax ID 27- 2887698
VOUCHER NO. WARRANT NO.
ALLOWED 20
coVita
IN SUM OF
30 Washington Ave., Suite B
Haddonfield, NJ 08033
$53.16
ON ACCOUNT OF APPROPRIATION FOR
Carmel HR Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
25878 V1557 43- 419.80 $53.16 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 19, 2011
Director, HR
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))
10/21/11 V1557 $53.16
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
20
Clerk- Treasurer