182038 02/03/2010 4 °•N, CITY OF CARMEL, INDIANA VENDOR: 233701 Page 1 of 1
ONE CIVIC SQUARE ORR SAFETY CORP
•!s I' CHECK AMOUNT: $340.00
k• CARMEL, INDIANA 46032 1266 RELIABLE PARKWAY
CHICAGO IL 60686 CHECK NUMBER: 182038
CHECK DATE: 2/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1506659 340.00 OTHER EXPENSES
lir
Orr Safety Corporation
11601 Interchange Drive �nvo�ce INV1506659
Louisville KY 40229
Da #e 1/19/2010
Amerce:( Safety Net Page 1
INVOICE
Bill To; Ship To:
CARMEL WASTEWATER TREAT PLT JEFF COOPER
CARMEL WASTEWATER TREAT PLT
9609 HAZEL DELL PKWY 9609 HAZEL DELL PKWY
INDIANAPOLIS IN 46280 INDIANAPOLIS IN 46280
Customer Il];', OrderNo a?acK Lisa No Shi in Method. ;,Pa
Purchase Order No pp g; ymenttTerms Master No:!.':'
JEFF COOPER 4015589 OSC NET 30 AR 2,186,733
"f]escriptlon Un
Drtlered:: 'Sttfpped r !B /0. ItemNumber Fact
ft Price': Price
4.00 4.00 0.00 LBRLVICR Service Labor Instrumentation C R $85.0000 $340.00
p f 1
JAN 19 2009 1]
By
Calibration of LEL IR monitors Subtotal $340.00
at waste water plant. Service performed M
5/13/09. Reference RA:f 322981. $0-00
Tax!' $0.00
$0.00
For Order and Billing Inquiries Call 502- 774 -6557 Amount Received $0.p0
Please Remit To 1266 Reliable Parkway, Chicago, IL 60686 Total otfe $340.00
VOUCHER 09721?• .WARRANT ALLOWED
233701 IN SUM OF
ORR SAFETY CORP
1266 Reliable Parkway
Chicago, IL 60686
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
1506659 01- 7362 -06 $340.00
Voucher Total $340.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
0°\
Prescribed by State Board of Accounts '\.City Form No. 201 (Rev 1995)
'I
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
233701
ORR SAFETY CORP Purchase Order No.
1266 Reliable Parkway Terms
Chicago, IL 60686 Due Date 12/30/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/200! 1506659 $340.00
I 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
Date Officer