HomeMy WebLinkAbout223658 08/27/2013 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: $421.10
INDIANAPOLIS IN 46203 CHECK NUMBER: 223658
CHECK DATE: 8/27/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 10060928 421 . 10 OTHER EXPENSES
INVOICE
State Safety & Compliance, LLC.
INVOICE
Branch: 701 Indianapolis 10060928
5358 Victory Dr Invoice Date Page
Indianapolis, IN 46203 8/15/2013 15:47:22 1 of I
ORDER NUMBER
3719630
317-423-7724
Bill To: Ship To:
Carmel Waste Water Treatment Carmel Waste Water Treatment
Attn: Paul Arnone Carnlel W.W.T. Attn: Blaine Mallaber
9609 Hazel Dell Parkway 9609 Hazel Dell Parkway(513682)
Indianapolis, IN 46280 Indianapolis, In 46280
Customer ID: 109095
PO Number Terms Description Net Due Date I Disc Due Date Discount Amount
513682 0.5% 10 net 30 09/14/13 08/25/13 1.90
Order Date Pick Ticket No Primary Salesrep Name Taker
8/1/2013 16:02:31 6066736 Gary Smith JCHANEY
Quantities Pricing
Item ID UOM Unit Extended
Ordered Shipped Remaining UOM 4 Item Description Unit Size Price Price
Unit Size 8
Delivery Instructions: UPS GROUND PREPAY& ADD
Carrier: UPS Ground- PPA Tracking#:IZ203YOA0355804211
23.0000 23.0000 0.0000 EA NRE1RWOlA00 EA 16.5000 379.50
1.0 HARD HAT WHITE FULL BRIM RACHET 1
FIBRE METAL--CLASS E,G,C TYPE 1
Total Lines:I SUB-TOTAL: 379.50
Total Freight In:0.00 Total Freight Out:41.60 TOTAL FREIGHT: 41.60
TAX. 0.00
AMOUNT DUE: 421.10
ORIGINAL
VOUCHER # 136230 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
10060928 01-7202-05 $421.10
i
Voucher Total $421.10
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 8/22/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/22/2013 10060928 $421.10
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