HomeMy WebLinkAbout206002 01/31/2012 CITY OF CARMEL, INDIANA VENDOR: 363840 Page 1 of 1
ONE CIVIC SQUARE STATE SAFETY COMPLIANCE LLC
CARMEL, INDIANA 46032 5338 VICTORY DRIVE STE A CHECK AMOUNT: $22.53
INDIANAPOLIS IN 46203 CHECK NUMBER: 206002
CHECK DATE: 1131/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 9879487 22.53 OTHER EXPENSES
INVOICE
State Safety Compliance, LLC.
INVOICE
Branch: 701 Indianapolis 9879487
5338 Victory Dr Invoice D ate Page
Suite A 1 1/18/2012 12:10:171 1 of 1
Indianapolis, IN 46203 Q r ORD ER N UMBER
3604158
317- 423 -7724 1
Bill To: Ship To:
City of Carmel Utilities City of Carmel Utilities
Wastewater Carmel W.W.T.P (JEFF COOPER 1- 18 -12)
760 Third Ave. SW, Suite 110 9609 Hazel Dell Parkway
Carmel, IN 46032 Indianapolis, In 46280
Customer ID: 109095'
PO Number Terms Description Net Due Date Disc Due Date Discount Amount
JEFF COOPER 1 -18 -12 0.5% 10 net 30 02/17/12 01/28/12 0.07
Order Date Pick Ticket No Printaty Salesrep Name Taker
1/18/2012 11:33:45 5885980 Rob Willmann JCHANEY
Ouantities Pricing
/ten. /D UL Unit Extended
c /tear Description Price Price
Ordered Shipped Remaining U�rtYlt Size O' Unit Size
Delivery Instructions: UPS GROUND PREPAY ADD
Carrier: UPS Ground PPA Tracking IZ203YOA0354603136
3.0000 3.0000 0.0000 DZ J9 DZ 4.9101 14.73
12.0 GLOVES BROWN JERSEY MENS 9 OZ LARGE 12
(25 /DZ PER CS.)
Total Lines: l SUB TOTAL: 14.73
Total Freight In: 0.00 Total Freight Out: 7.80 TOTAL FREIGHT 7,80
TAX: 0.00
AMOUNT DUE: 22.53
ORIGINAL
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 1/24/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/24/2012 9879487 $22.53
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
Date 0 ff r
VOUCHER 116652 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
9879487 01- 7202 -06 $22.53
Voucher Total $22.53
Cost distribution ledger classification if
claim paid under vehicle highway fund