181232 01/13/2010 °u., CITY OF CARMEL, INDIANA VENDOR: 00351010 Page 1 of 1
ONE CIVIC SQUARE HALSEN PRODUCTS
Q PO BOX 877 CHECK AMOUNT: $507.32
CARMEL, IN DIANA 46032
BELMONT MS 38827 CHECK NUMBER: 181232
N,
CHECK DATE: 1/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 R4356001 21419 0105033 —IN 365.06 GLOVES
2201 R4356001 21419 0105086 —IN 142.26 GLOVES
N V. PAGE:
HALSEN PRODUCTS COMPANY
P.O. BOX 877
BELMONT, MS 38827
NATIONWIDE 1 -800- 344 -6696 INVOICE NUMBER 0105033 IN
FAX 1 -800- 826 -8839
INVOICE DATE1 2/22/2009
ORDER NUMBER:
ORDER DATE:
SALESPERSON 5 2 3
CUSTOMER NOb 230327
SOLD TO SHIP TO
CT,TY OF CARMEL STREET DEPARTMENT
ACCOUNTS PAYABLE DEPT BONNIE CALLAHAN
3400 W 131ST ST 3400 WEST 131 STREET
Westfield, IN 46074 Westfield, IN 46074
CONFIRM TO
BONNIE
J CUSTOMER P.O. SHIP VIA „Fa6: TERMS
BONNIE UPS Net 30
ITEM NO. UNIT ORDERED SHIPPED BACK ORDER .PRICE s AMOUNT
BJM92K EACH 576 576 0 0.580 334.08
BROWN JERSEY GLOVE
net 334 0'8�
Less Discount: 0.00
THANK YOU FOR YOUR ORDER Freight: 30.98
Sales Tax: 0.00
Invoice Total: 365.06
Less Deposit: 0.00
3
INVOICE BALANCE
g I PAGE: 1
HALSEN PRODUCTS COMPANY
P.O. BOX 877
BELMONT, MS 38827
NATIONWIDE 1 806344 -6696 INVOICE NUMBER: 0105086 IN
FAX 1.800- 826 -8839
INVOICE DATE: 12/30/2009
ORDER NUMBER:
ORDER DATE:
SALESPERSON: 0523
CUSTOMER NO: 0230327
SOLD TO SHIP TO
CITY OF CARMEL STREET DEPARTMENT
ACCOUNTS PAYABLE DEPT BONNIE CALLAHAN
3400 W 131ST ST 3400 WEST 131 STREET
Westfield, IN 46074 Westfield, IN 46074
CONFIRM TO:
BONNIE
CUSTOMER P.O SHIP Vi,s FO;B a TERMS
BONNIE UPS Net 30
ITEM NO UNIT ORDERED SHIPPED :'BACK ,ORDER PRICE. AMOUNT
LW93 EACH 288 28E 0 0.450 129.60
STRING KNIT LINER
Net In-vo ce 129.
Less- -Discount 0.00
THANK YOU FOR YOUR ORDER Freight: 12.66
Sales Tax: 0.00
Invoice Total: 142.26
Less Deposit:. 0.00
14'2 -2
INVOICE BALANCE
VOUCHER NO. WARRANT NO.
ALLOWED 20
Halsen Products
IN SUM OF
P. O. Box 877
Belmont, MS 38827
$507.32
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street De•artment
4 4►
PO# Dept. INVOICE NO. CCT #!TITLE AMOUNT Board Members
21419 0105033 -IN 43- 560.01 $365.06 I hereby certify that the attached invoice(s), or
21419 0105086-IN 43- 560.01 $142.26
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
f} t A
;Thursday, /January 07, 2010
U J :j
i V
Street n? i ssi on s es ner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or 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
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/22/09 0105033 -IN $365.06
12130/09 0105086 -1N $142.26
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