HomeMy WebLinkAbout57813 NORTHERN SAFETY CO INC INDIANA RETAIL TAX EXEMPT PAGE 1
(2,4 qy r CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 57813
35-60000972
0 NE CIVIC SQUARE
C.ARMEL,INDIANA46032_2 84 THIS NUMBER MUST APPEAR ON INVOICES,A/P
VOUCHER,DELIVERY MEMO,PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
3/16/2023 03/19/23 30891 226500 PPE and Safety Supplies for PNR Field Staff
Northern Safety Co. Inc. Parks Maintenance
P.O. Box 4250 1427 E. 116th Street
VENDOR Utica, NY 13504-4250 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
4.000 each Item#408138 Certified Safety Certi-Gauze 5"x 9"Trauma Pad $ 1.170 $4.68
2.000 each Item# 199346 First Aid Only®SmartCompliance Triangular $4.650 $ 9.30
Bandages First Aid Kit Refill 2/Box
2.000 each Item#408385 First Aid Only®Hydrogen Peroxide Pump Spray $ 5.200 $ 10.40
2.000 each Item# 10254 First Aid Only®SmartCompliance Alcohol Wipes $4.750 $ 9.50
First Aid Cabinet Refill 20/Box
12.000 each Item#28929 ARI Tick StuffTM Bug Repellant Clothing $ 6.790 $ 81.48
Treatment Spray, 6 oz. Item#28929
2.000 each Item# 199354 First Aid Only®SmartCompliance Antibiotic $4.920 $ 9.84
Ointment Packets First Aid Kit Refill 20/Box
2.000 each Item#6404 NSI 2"x 3" Premium Fabric Adhesive First Aid $ 10.040 $20.08
Bandages, 50/Box
12.000 each Item# 1993 Croc Bloc TM 6 oz. Tube SPF 30 Sunscreen Cream $ 12.060 $ 144.72
10.000 each Item#4115 Honeywell 4 oz. Saline Solution Emergency First $ 5.860 $ 58.60
Aid Eye Wash
8.000 each Item#4113 Honeywell 1 oz. Saline Solution Emergency First $ 3.800 $ 30.40
Aid Eye Wash
8.000 each Item# 12238 AfterBite®0.5 oz.Advanced Formula Applicator $4.240 $ 33.92
Tube Insect Bite Itch Relief Liquid
Send Invoice To:
$ 776.37
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.NUMBER IS MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
▪ I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
. C.O.D SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Cody McCollum
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE Parks Coordinator
CONTROLLER
DOCUMENT CONTROL NO. 57813 VEEN IDOIR 4:;4: IF Y
INDIANA RETAIL TAX EXEMPT PAGE 2
qytIfy 1-11,
1,u ar CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 57813
35-60000972
ONE crnc SQUARE
C.ARMEL,IN DIANA 4E032-2 84 THIS NUMBER MUST APPEAR ON INVOICES,A/P
VOUCHER,DELIVERY MEMO,PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE.
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
3/16/2023 03/19/23 30891 PPE and Safety Supplies for PNR Field Staff
Northern Safety Co. Inc. Parks Maintenance
P.O. Box 4250 1427 E. 116th Street
VENDOR Utica, NY 13504-4250 SHIP Carmel, IN 46032
TO
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
12.000 each Item#24711 Off!®Deep Woods 6 oz. 25% DEET Insect $ 7.190 $ 86.28
Repellant Aerosol Spray
8.000 each Item#2657 Tec Labs®Tecnu Extreme®4 oz. Tube Poison $ 16.440 $ 131.52
Oak& Ivy Scrub
2.000 each Item#3057 CoreTex® IvyXTM Pre-Contact Barrier& IvyXTM $ 30.100 $ 60.20
Post-Contact Cleanser Towelettes, 50/Box
5.000 each Item#320933 Honeywell VeriShieldTM 100 Series Low Level $ 17.090 $ 85.45
NRR 24 Ear Muffs
GLAccount# 1125401-4239012
Send Invoice To:
$ 776.37
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.NUMBER IS MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
SHIPPING INSTRUCTIONS AFFIDAVIT ATTACHED.
▪ I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN THIS APPROPRIATION
• SHIP REPAID. SUFFICIENT TO PAY FOR THE ABOVE ORDER.
. C.O.D SHIPMENTS CANNOT BE ACCEPTED.
• PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABELS. ORDERED BY Cody McCollum
• THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. TITLE Parks Coordinator
CONTROLLER
DOCUMENT CONTROL NO. 57813 VENDOR COPY