186959 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
j ONE CIVIC SQUARE NORTHERN SAFETY CO, INC CHECK AMOUNT: $404.18
CARMEL, INDIANA 46032 PO Box 4250
q o �,�o UTICA NY 13504 CHECK NUMBER: 186959
CHECK DATE: 6123/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4239039 9901018 404.18 GENERAL PROGRAM SUPPL
KINORTHERN Remember... We Always Offer INVO
Our Lowest Price When You Order. PLEASE REFIT 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.com Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID I MAT LEBER
0004816021 CARMEL CLAY PARKS RECREATION
1235 CENTRAL PARK DR E
SOLD CARMEL, IN 46032
TO: CARMEL CLAY PARKS RECREATION
1411 E 116TH ST L
CARMEL, IN 4603200g0 ;1
23662 06/09/10
L J @';3Y3�338sS YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 07/09/10
INVOICE NO. /ORDER NO.
I053009901018 06/09/10 UPS GROUND 06/09/10
ORDERED SHIPPED ITEM NO, UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
50 50 305 -17754 WE 01 EA KRYLON UPSIDE DOWN STRIPING PAINT WHITE K08300 6.99 349.50
Purchase
Description
P.O.# a z Co laa, Po F
o.L# rn��- 5th- 1�3G y3�1
Line Dena 11 PrT SU,Zi es
Purchaser Date
Approv Data
SALES TAX SHIPPING HANDLING
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1 PER
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE 54.68 404.18
UNPAID BALANCE.
Payments must be payable in US dollars only
2% discount does not apply to credit card payments Thank You for Your Orders
FFnFRCI Ir)A 1R_191AA1A
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 bf 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
619110 1053009901018 Line paint 23662 404.18
Total 404.18
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
404.18
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1096 1o5moggolois 4239039 404.18 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
17 -Jun 2010
Signature
404.18 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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