HomeMy WebLinkAbout218631 03/25/2013 CITY OF CARMEL, INDIANA VENDOR: 363840 Page 1 of 1
ONE CIVIC SQUARE STATE SAFETY&COMPLIANCE LLC CHECK AMOUNT: $151.21
CARMEL, INDIANA 46032 5338 VICTORY DRIVE STE A
INDIANAPOLIS IN 46203 CHECK NUMBER: 218631
CHECK DATE: 3/25/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 10010150 151 .21 OTHER EXPENSES
INVOICE
State Safety & Compliance, LLC.
INVOICE
Branch: 701 Indianapolis 10010150
5338 Victory Dr Invoice Date Page
Suite A 3/12/2013 14:56:09 1 of 1
Indianapolis, IN 46203 ORDER NUMBER
3687005
317-423-7724
Bill To: Ship To:
Carmel Waste Water Treatment Carmel Waste Water Treatment
Attn: Paul Arnone BLAINE MALLABER 3-8-13
9609 Hazel Dell Parkway 9609 Hazel Dell Parkway
Indianapolis, IN 46280 Indianapolis, In 46280
Customer ID: 109095
PO Number Terms Description Net Due Date I Disc Due Date Discount Amount
BLAINE MALLABER 3-8-13 0.5% 10 net 30 04/11/13 03/22/13 0.71
Order Date Pick Ticket No Primary Salesrep Name Taker
3/8/2013 08:04:41 6016077 Gary Smith JCHANEY
Quantities Pricing
Item ID UOM Unit Extended
ii Itent Description Price Price
Ordered Shipped Remaining UOM � Unit Size
Unit Size O
Delivery Instructions: UPS GROUND PREPAY& ADD
Carrier: UPS Ground- PPA Tracking#:IZ203YOA0353457190
12.0000 12.0000 0.0000 EA GU-G1540BA EA 11.8000 141.60
1.0 EYEWASH 8OZ ADDITIVE BACTERIOSTATIC 1
GUARDIAN
Total Lines:I SUB-TOTAL: 141.60
Total Freight In:0.00 Total Freight Out.-9.61 TOTAL FREIGHT: 9.61
TAX: 0.00
AMO UNT D UE: 151.21
f
ORIGINAL
VOUCHER # 135132 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
10010150 01-7202-05 $151.21
Voucher Total $151.21
Cost distribution ledger classification if
claim paid under 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 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 3/18/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/18/2013 10010150 $151.21
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
Date Officer