250361 10/07/15 CITY OF CARMEL, INDIANA VENDOR: 226500
® ONE CIVIC SQUARE NORTHERN SAFETY CO, INC CHECK AMOUNT: S"""'344.16*
CARMEL, INDIANA 46032 Po Box 4250 CHECK NUMBER: 250361
9� OH`o i UTICA NY 13504 CHECK DATE: 10/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4239012 901621169 243.86 SAFETY SUPPLIES
1081 4239039 901623346 92.34 GENERAL PROGRAM SUPPL
1125 4239012 901623347 7.96 SAFETY SUPPLIES
KJORTHERN Remember... We Always Offer
• Our Lowest price When You Order. PLEASE REMIT TO:
PO Box 4250 ' uiica, 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
e•• e • • 4816021 Courtney
1427 E 1 16th St
SOLD Carmel Clay Parks&Recreation CARMEL IN 46032-3455
TO: 1411 E 116th St 7BY:
USA
CARMEL IN 46032-3455 J L
USA 2015
XX-2734 09/23/2015
YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 10/23/2015
INVOICE NO./ORDER NO.
1'52116,^,/980002324 09/23/2015 FEDEX GROUND - 09!23,2015- IF PAID BY 10/13/2015 PAY $ 239.30
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
4 4 26019 M PR MECHANIX UTIL GLV M UTIL GLV CG- 21.96 87.84
4 4 26019 L PR MECHANIX UTIL GLV L 21.96 87.84
8 7 22889 BG LEIGHTNING NRR23 HYGIENE KITS 1011998 7.46 52.22
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 $ 15.96 $ 243.86
UNPAID BALANCE.
Payments must be payable in US dollars only r
"2%discount does not apply to credit card payments Thank You-for Your-Ortier®- --
FEDERAL ID#16-1214814
�ORTHERN Remember... We Always Offerno
EEZZ ' 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 4
Utica, NY 13504-4250
SHIP TO(IF OTHER THAN"SOLD TO")
YOUR CUSTOMER ID F Cherry Tree Elementary
PLEASE REFER TO YOUR CUSTOMER,
•'• • 4816021 Tiffany
13989 Hazel Dell Parkway
SOLD Carmel Clay Parks&RecreationFBY:
CARMEL IN 46033-8748
TO. 1411E 116th St USA
CARMEL IN 46032-3455 9 2015 L
USA
XX-2739 09/24/2015
YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 10/24/2015
INVOICE NO./ORDER NO.
901623346 1980503673 09/24/2015 FEDEX GROUND 09/24/2015 IF PAID BY 10/14/2015 PAY $ 90.78
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
1 1 4351 BX TRIPLE ANTIBIOTIC OINTMENT 144/BX 28.72 28.72
1 1 4646 BX HYDROCORTISONE CREAM 1% 144/BX 19.50 19.50
12 12 7355 BX SPLINTER OUT HINGEDBX OF 20(50/CA SE) 2.50 30.00
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 _._- $ 14.12 $ 92.34
UNPAID BALANCE.
Payments must be payable in US dollars only
2%discount does not apply to credit card payments Thank You for Your Order!
FEDERAL ID#16-1214814
NORTHERN Remember... We Always OfferINVOICE
• Our Lowest Price When You Order. PLEASE REMIT To.
PO Box 4250 o 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
a, Utica, NY.13504-4250
SHIP TO(IF OTHER THAN"SOLD TO")
YOUR.CUSTOMER ID Carmel Clay Parks&Recreation
. • o • 4816021 Courtney
1427 E 1 16th St
SOLD Carmel Clay Parks&Recreation CARMEL IN 46032-3455
TO. 1411 E 116th St
� II USA
CARMEL IN 46032-3455 L�
By
USA SEP L 9 2015
XX-2734 09/24/2015
-- YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 10/24/2015
INVOICE NOJORDER NO.
01623347 1100920891 09/24/2015 FEDEX GROUND 09/24/2015 IF PAID BY 10/14/2015 PAY $ 7.81
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
1 1 22889 BG LEIGHTNING NRR23 HYGIENE KITS 1011998 7.46 7.46
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 $ 0.50 $ 7.96
UNPAID BALANCE.
Payments must be payable in US dollars only
"2%discount does not apply to credit card payments Thank You for Your Order!
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.
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
9/23/15 901621169 Safety supplies xx2734 $ 243.86
9/24/15 901623346 First Aid supplies for ESE CT xx2739 $ 92.34
9/24/15 901623347 Safety supplies xx2734 $ 7.96
Total $ 344.16
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
, 20
Clerk-Treasurer
Voucher No. Warrant No.
226500 Northern Safety Co., Inc.
P.O. Box 4250 Allowed 20
Utica, NY 13504-4250
In Sum of$
$ 344.16
ON ACCOUNT OF APPROPRIATION FOR
101 General/108 ESE
PO#or
Dept# INVOICE NO. ACCT#/TITL AMOUNT
Board Members
1125 901621169 4239012 $ 243.86
I hereby certify that the attached invoice(s),
1081-2 901623346 4239039 or
1125 901623347 4239012 $ 92.34 bill(s) is(are)true and correct and that the
$ 7.96 materials or services itemized thereon for
which charge is made were ordered and
received except
October 1, 2015
PAU"VXtAj
$ 344.16 Signature
Cost distribution ledger classification if Accounts Payable Coordinator
claim paid motor vehicle highway fund Title