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Home My WebLink About208672 05/10/2012 CITY OF CARMEL, INDIANA VENDOR: 354610 Page 1 of 1 ONE CIVIC SQUARE EPDXY FLOORING SPECIALISTS INC CHECK AMOUNT: $3,450.00 CARMEL, INDIANA 46032 15275 STONY CREEK WAY, SUITE A o` NOBLESVILLE IN 46060 CHECK NUMBER: 208672 CHECK DATE: 5/10/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1110 R4350100 25940 2950 3,450.00 FLOORING SYSTEM Epoxy Flooring Specialists Invoice 15275 Stony Creek Way Date Invoice Suite A Noblesville, IN 46060 4/25/2012 2950 Bill To City of Carmel c /o: Denise Bristow One Civic Sqaure Carmel, IN 46032 P.O. No. Terms Project Project Verbal R Robinson Due on receipt Police Department Quantity Description Rate Amount 1 Two Coat Decorative L'poxy f=looring System 3,450.00 3,450.00 Total $3.450.00 Payments /Credits $0.00 Balance Due $3.450.00 Phone Fax E -mail 317- 774 -2600 317- 774 -8420 EFSTODD a AOL.COM INDIANA RETAIL TAX EXEMPT PAGE Co CERTIFICATE NO. 003120155 002 0 PURCHASE ORDER NUMBER FEDERAL EXCISE TAX EXEMPT 2.40 35- 60000972 ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS, SHIPPING LABELS AND ANY CORRESPONDENCE. FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 'URCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION 92d�Q1�099 Epoxy Flooring Specialisto Camel Police DGmdmont VENDOR SHIP 3 CIVIC Squ2m 15295 Irony CmQh Vft TO c2rmGl, IN 4m Noblosvillo, IN 461 (399) 5990 CONFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION Account 43-01.0 9 Each Two cost Decorative Epoxy Flooring $3,450.00 $3,450.00 �t�elrl Sub Total: $3,450.00 Send Invoice To: r C@rmGI Pollco Mpadmon4 Attn: TGms2 Andomon 3 CIVI squm Camol, IN 4M- PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT Carmel Police Dept. PAYMENT $3'40'00 A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED. SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN SHIP REPAID. THIS APPROPRIATION SUVFICIENT TO PAY FOR THE ABOVE ORDER. C.O.D. SHIPMENTS CANNOT BE ACCEPTED. PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY Y! SHIPPING LABELS. Ad of I� ®IIcG THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. CLERK TREASURER DOCUMENT CONTROL NO. 2 5 9 f A 1 0 A.P.V. COPY SIGN AND RETURN TO CLERK'S OFFICE VOUCHER NO.______ WARRANT NO. ALLOWED 20__. |N THE SUM OF$ ON ACCOUNT OF APPROPRIATION FOR Board Members PO, pr INVOICE hereby certify that the attached invoico(s),or bill(s) �iekan��ueandoorneotondthatthe materials or services itemized thereon for which charge iu made were ordered and received except 20 Signature Title Cost distribution le dger 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)) 04/25/12 2950 epoxy garage floor $3,450.00 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 NO. WARRANT NO. ALLOWED 20 Epoxy Flooring Specialists IN SUM OF 15275 Stony Creek Way Noblesville, IN 46060 $3,450.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Police Department PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members Encumbered I hereby certify that the attached invoice(s), or 25940 I 2950 43- 501.00 $3,450.00 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 Wednesday, May 02, 2012 Chief of Police Title Cost distribution ledger classification if claim paid motor vehicle highway fund