NCS000453_Indian Trail_Streetsweeping Invoice_20200805

TOWN OF INDIAN TRAIL NO. 013856
REFERENCE/DESCRIPTION NET AMOUNT
vendor: SOUTH110 Southland Pavement Cleaning
P0: 20-01242 DESC: Townwide street sweeping 9,000.00
INV: 117785S AMT: 9,000.00
check Date: 03/11/20 check Amount: $***** 9,000.00
DETACH BEFORE DEPOSITING
TOWN OF MDIAN TRAIL
GENERALFUND
PROVISION FOR THE PAYMENT OF THIS CHECK HAS
BEEN MADE BY AN APPROPRIATION DULY MADE PURSUANT
INIDIAN RAiLrig
TO THE LOCAL GOVERNMENT AND FISCAL CONTROL ACT
ROI`h Carolina VOID AFTER 180 DAYS
DATE
03/11/20
Nine Thousand AND 00/100 Dollars
r
Southland Pavement Cleaning
TO THE PO BOX 5354
ORDER OF Concord, NC 28027
BUT
BRANCH BANKING AND TRUST COMPANY
NORTH CAROLINA
66-112-531
CHECK NO.
13856
No. 013856
AMOUNT
$***** 9,000.00
L
nafl17DCI'u■ ■•MC71f-111 71■■Mr1flC1Mf`77CC7r-11.0
AUTHORIZED SIGNATURE
SIGNATURE

TOWN OF INDIAN TRAIL
I PO Box 2430
c Indian Trail, NC 28079
Phone: [phone]
Fax: [phone]
SHIP TO
VENDOR Vendor#: SOUTH110
Southland Pavement Cleaning
PO Box 5354
Concord, NC 28027
Phone#: [phone] Fax#: [phone]
Purchase Order
THIS NUMBER MUST APPEAR ON ALL INVOICES,'
PACKING LISTS, CORRESPONDENCE, ETC.
NO.20-01242
ORDER DATE: 02/03/20
REQUISITION NO: RO-00257
DELIVERY DATE:
STATE CONTRACT:
F.O.B. TERMS: Destination
VENDOR ACCT NUM:
PAYMENT RECORD
CHECK NO.
DATE PAID
NOTICE: TAX ID: 56-1108235
QUANTITY DESCRIPTION ACCOUNT NO UNIT PRICE TOTAL
1.00 Townwide street sweeping 60-90-7500-397-000 9,000.0000 9,000.00
TOTAL 9,000.00
Sales Tax
State
County
20 Food
Total Tax
Total PO I -(�'
APPROVAL TO PURCHASE
This Instrument has been pre -audited in
IRAN DIVESTMENT ACT CERTIFICATION
REQUIRED BYN.C.G.S. 143C-6A-5(a)
Entered By:
the manner required by the Local
IAct.
Govern offip2mm
&AA
Reviewed By:
By acceptance of this purchase order, vendors,
Finance Director
contractors, and/or subcontractors affirm
0 Ar-
they are not listed and will not utilize a
Approved
subcontractor listed on the Final Divestment
List created by the State Treasurer pursuant
INT:
Town Manager
to N.C.G.S. 143-6A-4, Iran Divestment Act
Certification.
Date:

Si-d SOUTHLAND PAVEMENT CLEANING,
PPaLRgiCnt PO Box 5354
[leaning
" Concord. NC 28027
www.SouthlandPavementCleaning.com
Bill To
TOWN OF INDIAN TRAIL
Project
INVOICE
Date Invoice #
2/29/2020 117785S
Terms
Due Date
P.O. No.
Net 30
3/30/2020
Del Rcpt
Quantity
Description
Rate
Serviced
Amount
1
STREET/PARKING LOT SWEEPING-
9,000.00
2/29/2020
9,000.00
FLAT RATE
PoZa-01J,1�a- (Co"'-p
�J
l0-75 00
Phone #
Total $9,000.00
Fax #
E-mail
7049381512 x102
[phone]
[e-mail]

NO INDIAN TRAIL
I PO Box 2430
it Indian Trail, NC 28079
Phone: [phone]
Fax: [phone]
_SHIP TO
VENDOR Vendor #: SOUTx110
Southland Pavement Cleaning
PO Box 5354
Concord, NC 28027
Phone#: [phone] Fax#: [phone]
Purchase Order
THIS NUMBER MUST APPEAR ON ALL INVOICES,
PACKING LISTS, CORRESPONDENCE, ETC.
N0.20-01242
ORDER DATE: 02/03/20
REQUISITION NO: RO-00257
DELIVERY DATE.
STATE CONTRACT:
F.O.B. TERMS: Destination
VENDOR ACCT NUM:
PAYMENT RECORD
CHECK NO.
DATE PAID
NOTICE: TAX ID: 56-1108235
QUANTITY ;DESCRIPTION ACCOUNT NO UNIT PRICE TOTAL
1.00 Townwide street sweeping 60-90-7500-397-000 9,000.0000 9,000.00
TOTAL 9,000.00
Sales Tax
State
County
20 Food
Total Tax
I
I
I Total PO I
APPROVAL TO PURCHASE
This Instrument has been pre -audited in
IRAN DIVESTMENT ACT CERTIFICATION
Entered By:
the manner required by the Local
REQUIRED BYN.C.G.S. 143C-6A-5(a)
Governm nt Budget nd Fiscal on rol Act.
Reviewed By:
By acceptance of this purchase order, vendors,
Finance Dire r
contractors, and/or subcontractors affirm
they are not listed and will not utilize a
subcontractor listed on the Final Divestment
M��Z 4 Z0
Approved
List created by the State Treasurer pursuant
INT:
to N.CG.S. 143-6A-4, Iran Divestment Act
Certification.
Date: