184418 04/14/2010 a CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
ONE CIVIC SQUARE NORTHERN SAFETY CO, INC
CHECK AMOUNT: $243.97
CARMEL, INDIANA 46032 Po sox azso
s: o UTICA NY 13504 CHECK NUMBER: 184418
CHECK DATE: 4/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1093 4239012 I05060820102 243.97
NORTHERN, Remember... We Always O ffer
Our Lowest price When You Order. PLE To:
PO Box 4250 Utica, NY 13504-4250 100% Satisfaction Guaranteed! NORT.HERN_SAFETY CO- NC. i
Phone: 800. 631 1246 Fax: 800. 635.1591 P.O. Box 425
northernsafety.com Utica, NYY113504 -4256
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID FARMEL CLAY PARKS RECREATION
0004816021 1411 E 116TH ST
CARMEL, IN 46032
TO CARMEL CLAY PARKS RECREATION
1411 E 116TH ST
CARMEL, IN 46032 L-
,1 03/31/10
L- YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 04/30/10
INVOICE NOJORDER NO.
I050608201022 03/3 0 UPS GROUND 03/31/10
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
2 2 152 -7700 S 02 EA HALF MASK SILICONE RESPIRATOR 7700 -30 SMALL 24.50 49.00
3 3 152 -7700 M 02 EA HALF MASK SILICONE RESPIRATOR 7700 -30 MEDIUM 24.50 73.50
1 1 152- 7700.L 02 EA HALF MASK SILICONE RESPIRATOR 7700 -30 LARGE 24.50 24.50
7 7 153 -3959 01 PR NORTH P100 PARTICULATE CARTRIDGE 758OP100 8.00 56.00
2 2 121 -6780 01 PR NEOPRENE COATED GLOVE 12" LENGTH SMOOTH FINISH 6.79 13.58
2 2 136 -1388 01 EA HEAVY.DUTY PVC APRON GREEN 35" X 45" PVC -45G 6.58 13.16
1 1 SP2010CAT 01 EA 2010 CATALOG .00
Purdwe
P
P.O.O PorF APR 0 20 0
Q.L F 1 DCi
Bud et BY.
Unevesc r
Purchaser t)ste f
Approver to
SALES TAX SHIPPING &HANDLING
ACCOUNTS DAYS AND OVER ARE T TO A FINANCE C HARGE OF 1 PER
MONTH WHI IS AN ANNUAL PERCENTAGE NTAGE B
RATE OF 16% TO BE APPLIED TO THE
UNPAID BALANCE.
Payments must be payable in US dollars only
2% discount does not apply to credit card payments T hank You for Your Orded
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
226500 Northern Safety Co., Inc. Terms
P.O. Box 4250
Utica, NY 13504 -4250
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
3/31110 1050608201022 Safety supplies 243.97
Total 243.97
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
Voucher No. Warrant No.
226500 Northern Safety Co., Inc. Allowed 20
P.O. Box 4250
Utica, NY 13504 -4250
In Sum of
243.97
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1093. 1050608201022 4239012 243.97 1 hereby certify that the attached invoice(s), or
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
8 -Apr 2010
P�h&mr�
Signature
243.97 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund