HomeMy WebLinkAbout208672 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