HomeMy WebLinkAbout58187 NORTHERN SAFETY CO INC INDIANA RETAIL TAX EXEMPT PAGE 1
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1,u ar CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 58187
35-60000972
ONE crnc SQUARE
CARMEL,INDIANA 4E0 32_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
5/26/2023 05/29/23 31656 226500 PPE and Safety Supplies for PNR
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
2.000 each Item#6405 NSI 1"x 3" Premium Fabric Adhesive First Aid $ 7.530 $ 15.06
Bandages, 100/Box
15.000 each Item#96311 NSI N-Specs®Low Profile OTG Gray Lens Over- $ 3.140 $47.10
the-Glass Safety Glasses
12.000 each Item#320933 Honeywell VeriShieldTM 100 Series Low Level $ 18.140 $217.68
NRR 24 Ear Muffs
GLAccount# 1125401-4239012
Send Invoice To:
$279.84
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. 58187 VII=::INIDO COPY
