249374 09/09/15 Q
CITY OF CARMEL, INDIANA VENDOR: 226500
ONE CIVIC SQUARE NORTHERN SAFETY CO, INC CHECK AMOUNT: $**""*"*127.76*
CARMEL, INDIANA 46032 PO BOX 4250 CHECK NUMBER: 249374
UTICA NY 13504 CHECK DATE: 09/09/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 901570570 127.76 GENERAL PROGRAM SUPPL
JUORTHERN Remember... We Always Offer •
0 0 Our Lowest Price When You Order.
PLEASE REMIT T0:
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 Carmel Clay Parks&Recreation
PLEA OANDYOUR CUSTOMER: . • INVOICE
COMMUNICATIONS4816021 Jennifer
3495 W. 126th Street
SOLD Carmel Clay Parks&Recreation CARMEL IN 46032-9557
TO: 1411 E 116th St EAU
USA
CARMEL IN 46032-3455 L
usA 2015X-2624 08/19/2015
Yew
YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 09/18/2015
INVOICE NOJORDER NO.
01570570 1 980487991 08/19/2015 FEDEX GROUND 08/19/2015 IF F> .j3Y D9/O.8/201 5 PAY $ 125.56
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
8 8 4444 BX BAND-AID FABRIC STRIPS 1 X 3 100 BX 6.99 55.92
2 2 30918 BX BZK ANTISEPTIC WIPES 100BX 1303 2.95 5.90
4 4 24778 EA 1 st AID SPRAY HYDROGEN PEROXIDE HP2-24 3.05 12.20
1 1 7259 BX STERILE PADS 2"X 2" 100BX 10.19 10.19
2 2 24799 EA IRRIGATE EYE WASH 1 OZ 19828 2.57 5.14
1 1 24848 BX IVYX PRE-CONTACT TOWLETTE 25/BX 16.63 16.63
2 2 13963 EA HYDROCORTISONE CREAM 1% 1 OZ TUBE 2.13 4.26
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 $ 17.52 $ 127.76
UNPAID BALANCE.
Payments must be payable in.US_dollam only. _
ply to credit card payments Thank You for Your ®rder!
FEDERAL ID#16-1214814
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.
Terms
226500 Northern Safety Co., Inc.
P.O. Box 4250
Utica, NY 13504-4250
Invoice Invoice Description PO# ntDate Number (or note attached invoice(s)or bill(s))8/19/15 901570570 First aid supplies �oc2624T;;Amou
127.76
--------------
Total $ 127.76
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$
$ 127.76
ON ACCOUNT OF APPROPRIATION FOR
108 ESE
PO#or Board Members
Dept# INVOICE NO. ACCT#/TITL AMOUNT
1081-10 901570570 4239039 $ 127.76 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
September 8, 2015
Signature
$ 127.76 _ Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund