241801 02/03/15 9, �,4�q
��,% '' CITY OF CARMEL, INDIANA VENDOR: 226500
ONE CIVIC SQUARE NORTHERN SAFETY CO, INC CHECK AMOUNT: $*******135.61*
UTICA CARMEL, INDIANA 46032 PO BOX 4250 CHECK NUMBER: 241801
'�iroN. .` UTICA NY 13504 CHECK DATE: 02/03/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 901240889 135.61 OTHER EXPENSES
A192RTHERN Remember...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
PLEASE REFER TO YOUR CUSTOMERto,OUR'INVOICE AND Carmel Utilities
.•• . IN ALL COMMUNICATIONS. . INVOICE
346023 Daniel
4915 E 106th St
SOLD CARMEL IN 46033-3800
TO: Carmel Utilities USA
3450 W 131 st St L
CARMEL IN 46074-8267
USA
DanO11215D 01/12/2015
YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 02/11/2015
INVOICE NO./ORDER NO.
01240889/100700672 1 01/12/2015 FEDEX GROUND 01/12/2015 IF PAID BY 02/01/2015 PAY $ 133.23
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
1 1 1760210 PR DR MARTENS WELLINGTONS STEEL TOE SZ 10 118.95 118.95
SALES TAX SHIPPING&HANDLING •
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 11/2%PER
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18%TO BE APPLIED TO THE
UNPAID BALANCE. $ 0.00 $ 16.66 $ .135.61
__.___P_ayments_must_be_payable in-US-dollars only
"2%discount does not apply to credit card payments Thank You for Your Order!
I FEDERAL ID#16-1214814
VOUCHER # 142831 WARRANT# ALLOWED
226500 IN SUM OF $
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NORTHERN SAFETY CO, INC 1
PO BOX 4250 j
UTICA, NY 13504
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Carmel Water Utility
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ON ACCOUNT OF APPROPRIATION FOR
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Board members
PO# INV# ACCT# AMOUNT ti Audit Trail Code
;t
901240889 01-6200-03 $135.61
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Voucher Total $135.61
Cost distribution ledger classification if
claim paid under vehicle highway fund
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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.
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Payee
226500
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NORTHERN SAFETY CO, INC i Purchase Order No.
PO BOX 4250 Terms
UTICA, NY 13504 Due Date 1/23/2015
Invoice Invoice Description
Date Number (or note attached;invoice(s) or bill(s)) Amount
1/23/2015 901240889 $135.61
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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
�/'�/,s Lam,..,--r✓K',.�.;ni�_
Date Officer