240765 01/07/15 �4q-
y.. CITY OF CARMEL, INDIANA VENDOR: 226500
b 'r! ONE CIVIC SQUARE NORTHERN SAFETY CO, INC CHECK AMOUNT: $**.....1 19.28'
CARMEL, INDIANA 46032 Po Box 4250 CHECK NUMBER: 240765
UTICA NY 13504 CHECK DATE: 01/07/15
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 901202894 119.28 GENERAL PROGRAM SUPPL
NORTHERN Re.-member..We Always Offer
- Our Lowest Price When You Order.
PLEASE REMIT TO:
PO Box 4250 • Utica, NY 13504-4250 100%Satisfaction Guaranteed! NORTHERN SAFETY CO.,INC.
Phone: 800.631.1246 • Fax: 800.635.1591 P.O.Box 4250
northernsafety.com Utica, NY 13504-4250
SHIP TO(IF OTHER THAN"SOLD TO")
YOUR CUSTOMER ID
•YOUR CU§TOMERIID,OUR INVOICECarmel Clay Parks&Recreation
.•. . IWALL COMMUNICATIONS REGARDINGTHIS INVOICE,
4816021 Valeska
10721 West Lakeshore Drive
SOLD CARMEL IN 46033-3928
TO: Carmel Clay Parks&Recreation
USA
1411 E 1 16th St
CARMEL IN 46032-3455 7DEC
USA 5 2014 XX-,474 ,2/08/20,4L— i YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 01/07/2015
INVOICE NO./ORDER NO.
01202894/980377312 12/08/2014 FEDEX GROUND 12/08/2014 IF PAID BY 12/28/2014 PAY $ 117.17
ORDERED SHIPPED ITEM NO. LOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
5 5 4434 BX BAND-AID FABRIC STRIPS 3/4 X 3 100BX 6.69 33.45
9 9 3901 EA MICROSHIELD CPR PROTECOR 70-150 50CS 6.36 57.24
5 5 4406 EA SURGICAL SCISSOR SS STEEL 4.5' 2.99 14.95
SALES TAX SHIPPING&HANDLING •
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 11h%PER
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18%TO BE APPLIED TO THE $ 0.00 $ 13.64 S 119.28
UNPAID BALANCE.
Povments must be aaiable in US dollars only
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
226500 Northern Safety Co., Inc. Terms
P.O. Box 4250
Utica, NY 13504-4250
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
12/8/14 901202894 Program supplies xx1474 $ 119.28
Total $ 119.28
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accoidance
with IC 5-11-10-1.6
20_
Clerk-Treasurer
Voucher No. Warrant No.
226500 Northern Safety Co., Inc. Allowed 20
P.O. Box 4250
Utica, NY 13504-4250
4 In Sum of$
$ 119.28
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1081-4 901202894 4239039 $ 119.28 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
January 2, 2015
Signature
$ 119.28 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund