182027 02/03/2010 CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
ONE CIVIC SQUARE NORTHERN SAFETY CO, INC CHECK AMOUNT: $191.49
CARMEL, INDIANA 46032 PO 80X4250
-7-*,i, UTICA NY 13504 CHECK NUMBER: 182027
CHECK DATE: 2/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 26053410102 191.49 OTHER EXPENSES
NORTH Remember... We Always Offer INVOICE
NORTHERN
&;1rhdusti-ial 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. Utica, NY 13504 4250
SHIP TO (IF OTHER THAN "SOLD TO
9 w c1 -e;.; r i. o 1 YOUR CUSTOMER ID CITY OF CARMEL
a 8� PLEASE REFER TO YOUR,YOUR CUSTOMER ID OUR I AND. 5
J ag ORDER NO MALL COMMUNICATIONS REGAR93NGrTHIS INVOICES l 0002411866 5484 EAST 126TH STREET
CARMEL, IN 46033
TOL CITY OF CARMEL
ATTN UTILITIES DEPT
3450 W 131ST ST L
WESTFIELD, IN 46074
KRIS 01/13/10
L___ YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 02/12/10
INVOICE NO. /ORDER NO.
P260534101021 01/13/10 UPS GROUND 01/13/10 IF PAID BY 02/02/10 PAY, $187.85
ORDERED 'SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
1 1 145 -9231 8 02 PR HARLEY DIP STICK STEEL TOE BOOTS SIZE 8 103.82 103.82
1 1 145 -26406 105 01 PR TIMBERLAND PRO STEEL TOE SPORT HIKER SZ10550500 77.95 77.95
1 1 325 -2010 CAL 01 EA 2010 NORTHERN SAFETY CALENDAR .00
1 1 SP2010CAT 01 EA 2010 CATALOG .00
SALES TAX SHIPPING HANDLING TOTAL DUE l
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF f' /z PER
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE 9./2 1 .4
UNPAID BALANCE.
Payments must be payable in US dollars only
2% discount does not apply to credit card payments Thank Yo for Your Order!
VOUCHER 094208 —WAkRANT ALLOWED
F
226500 IN SUM OF$
NORTHERN SAFETY CO, INC
PO BOX 4250
UTICA, NY 13504 �V,���∎
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
26053410102 01- 6200 -03 $191.49
r
Voucher Total $191.49
ti
ost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
226500
NORTHERN SAFETY CO, INC Purchase Order No.
PO BOX 4250 Terms
UTICA, NY 13504 Due Date 1/25/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/25/2010 2605341010; $191.49
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
Date Officer