246914 06/30/1 5 9�'
CITY OF CARMEL, INDIANA VENDOR: 226500
ONE CIVIC SQUARE NORTHERN SAFETY CO, INC CHECK AMOUNT: S""'"*"501.30'
CARMEL, INDIANA 46032 Po Box 4250 CHECK NUMBER: 246914
UTICA NY 13504 CHECK DATE: 06/30/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4239012 901453544 252.40 SAFETY SUPPLIES
1093 4238000 901470502 248.90 SMALL TOOLS & MINOR E
�ORTHERN Remember...We Always Offer
• Our Lowest Price When You Order. PLEASE REMIT TO.
PO Box 4250 . Utica, NY 1 3504-4250 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 IDREFER TO YOUR CAUISTOMER11D-OUR INVOIC 'D Carmel Clay Parks&Recreation
''' "ARDING THIS,INVOICE4816021 Courtney
1427 E. 1 16TH STREET
SOLD Carmel Clay Parks&Recreation CARMEL IN 46032
TO: USA
1411 E 1 16th St 7BY:L-
t�
CARMEL IN 46032-3455 r� �-�USA 2015XX-2251 06/03/2015
YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 07/03/2015
INVOICE NO./ORDER NO.
ninc36^q;980151.9Q' 05/03/2015 FEDEX!G R 0 N1 06,02/201F _
P'Air B-i:uG/2s/20i5 PAY,$ 2:47.77
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
3 3 26019 XL PR MECHANIX UTIL GLV XTRA L 22.43 67.29
2 2 26019 M PR MECHANIX UTIL GLV M UTIL GLV CG- 22.43 44.86
2 2 4534 EA POISON OAK-N-IVY CLEANSER 12 OZ 11.10 22.20
2 2 22888 EA LEIGHTNING L3 NRR 30 EAR MUFFS 1010924 26.36 52.72
5 5 26521 EA ZTEK EYEWR CLR LENS S2510S 2.43 12.15
4 4 14596 EA BUG BARRIER 2 120Z INSECT REPELLENT 12CS 8.10 32.40
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 $ 0,00 $ 20.78 $ 252.40
UNPAID BALANCE. '
Payments must be payable in US dollars only
�I
ORTHERN Remember...We Always Offer o
N ° Our Lowest Price When You Order. PLEASE REMIT TO:
PO B,ox 424. 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 Carmel Clay Parks&Recreation
' ' ' • "' ' 4816021 Mike
1235 CENTRAL PARK DRIVE EAST
SOLD Carmel Clay Parks&Recreation CARMEL IN 46032-4421
TO: USA
1411 E 116th St
CARMEL IN 46032-3455 �j)�~�•g-,.� r
USA
JUN 19 2015 XX-2299 06/15/2015
L ' I
j YOUR PURCHASE ORDER NUMBER AND DATE
OUR
INVOICE N ORDER NO. INVOICE DATE 'SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 07/15/2015
61470502 1 9$Q45"50 (1§11C)16Q.R./1Fj2n1F Inci�l✓3d1u.:/v:,f2t7�5rAY$'._-"'-:.J4
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
2 2 3959 PR NORTH P100 PARTIC CART 7580P100 9.14 18.28
2 2 3950 PK NORTH ORGANIC VAPOR CART 2PK N75001 12.46 24.92
4 4 2889415 EA NS INFUSION READERS MAGNIFICATION 1.5 6.99 27.96
12 12 26521 EA ZTEK EYEWR CLR LENS S2510S 2.31 27.72
2 2 3551 BX NORTHERN PRE-MOISTENED LENS CLEANING TOW 8.00 16.00
8 8 26497 EA NEMESIS EYEWR BE MIRK BK FRAME V30 6.99 55.92
2 2 7700 L EA HALF MASK SILICONE RESPIR 7700-30 L 28.64 57.28
SALES TAX SHIPPING&HANDLING e o
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 $ 0,00 $ 20.82 $ 248.90
UNPAID BALANCE.
Payments must be payable in US dollars only
04 J" 4—
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g
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
6/3/15 901453544 Safety supplies for staff and inventory xx2251 $ 252.40
6/15/15 901470502 PPG supplies xx2299 $ 248.90
Total $ 501.30
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
120
Clerk-Treasurer
Voucher No. Warrant No.
226500 Northern Safety Co., Inc. Allowed 20
P.O. Box 4250
Utica, NY 13504-4250
In Sum of$
$ 501.30
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund / 109 Monon Center
PO#or Board Members
Dept#
INVOICE NO. ACCT#/TITL AMOUNT
1125 901453544 4239012 $ 252.40 1 hereby certify that the attached invoice(s), or
1093 901470502 4238000 $ 248.90 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
June 25, 2015
Signature
$ 501.30 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund