HomeMy WebLinkAbout226689 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 00351010 Page 1 of 1
ONE CIVIC SQUARE HALSEN PRODUCTS
!€ CHECK AMOUNT: $675.17
CARMEL, INDIANA 46032 PO BOX 877
BELMONT MS 38827 CHECK NUMBER: 226689
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4356003 0119826-IN 675 . 17 SAFETY ACCESSORIES
V�� 1
HALSEN PRODUCTS COMPANY VE PAGE:
P.O.BOX 877
BELMONT,MS 38827
NATIONWIDE 1-800-344-6696 INVOICE NUMBER:
FAX 1.800-826-8839 0119';;2 6-T N
INVOICE DATE: 11/12/2013
ORDER NUMBER:
ORDER DATE:
SALESPERSON: 0523
CUSTOMER NO: 0 2 303?7
SOLD TO SHIP TO
CITY OF CAR.MEL STREET DEPT
ATTENTION ACCOUNTS PAYABLE JIM HOBBS
3400 W 131ST ST 3400 WEST 131 STREET
Cp.RMEL, IN 46074 CARMEL, IN 46074
CONFIRM TO:
iIM_ HOBBS
CUSTOMER P.O. SHIP VIA F.O.B. TERMS
STOCK UPS
Net 30
ITEM NO. UNIT ORDERED SHIPPED BACK ORDER PRICE AMOUNT
TC-1'cFLBB EACH 100 100 0 5.750 575 .00
n
TRAFFIC CON W/BLA K BASE
Net Invoice: 575 .00
THANK YOU FOR YOUR ORDER ! !
Freight : 100 . 17
_.ales Tax: 0 .00
------------------
Invvice Total,• 675 .17
Less Der>osit 0 .00
675 . 17
INVOICE BALANCE
VOUCHER NO. WARRANT NO.
ALLOWED 20
Halsen Products
IN SUM OF $
P. O. Box 877
Belmont, MS 38827
$675.17
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE I AMOUNT
Board Members
2201 1 0119826-IN 1 43-560.031 $675.17 1 hereby certify that the attached invoice(s), or
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
Tuesdpy No er 26, 2013
Street Commiss r
Street Co ;lVissioner
Cost distribution ledger 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))
11/12/13 0119826-IN $675.17
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