187972 07/21/2010 CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
ONE CIVIC SQUARE NORTHERN SAFETY CO, INC CHECK AMOUNT: $545.28
CARMEL, INDIANA 46032 PO Box 4250
UTICA NY 13504 CHECK NUMBER: 187972
CHECK DATE: 7/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4239000 197.78 I053344801014
1125 4239012 12.16 20153397201047
1125 4239012 159.42 I053397201013
1125 4239012 14.91 2053397201039
601 5023990 P2747455010 161.01 OTHER EXPENSES
N OR THERN Remember... We Always Offer
M 3 EASE Our Lowest Price When You Order. PL 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.com Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID CITY OF CARMEL
0002411866 5484 EAST 126TH STREET
CARMEL, IN 46033
TOL CITY OF CARMEL
ATTN UTILITIES DEPT
3450 W 131ST ST L_
WESTFIELD, IN 46074
DANIEL 06/29/10
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED
INVOICE NOJORDER NO. PAYMENT DUE BY 07/29/10
P274745501010 06/29/10 UPS GROUND 06/29/10 IF PAID BY 07/19/10 PAY $158.04
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
1 1 145 -22400 BK 10 01 PR DR MARTENS HIKER STEEL TOE BOOT BLACK SIZE 10 109.80 109.80
13 13 232 -5061 01 EA FIRE EXTINGUISHER SIGNS (VERTICAL) M23 -P 2.99 38.87
SALES TAX SHIPPING HANDLING
ACCOUNTS 36 BAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF P/s PER 12.34 161.01
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE
UNPAID BALANCE.
Payments must be payable in US dollars only d�
2 discount does -not apply to credit card payments ThCd9'SGC You for Your 'Order.
Ppnr=PGI If11t iR -191 dR1d
VOUCHER 102127 WARRANT ALLOWED
226500 IN SUM OF
NORTHERN SAFETY CO, INC a`
PO BOX 4250 d)
UTICA, NY 13504
X 0 0
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
P2747455010 01- 6200 -04 $161.01
Voucher Total $161.01
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form Flo. 241 (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 7/12/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/12/2010 P2747455011 $161.01
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
7 //G `iryVftin Date Officer Officer
v
Remember... We Always Offer
N OR T HERN 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. cam Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID C ARMEL CLAY PARKS RECREATION
m om 0004816021 1411 E 116TH ST
CARMEL, IN 46032
TO AARMEL CLAY PARKS RECREATION
1411 E 116TH ST
CARMEL, IN 46032 L
101 1125 4239012 06/21/10
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 07/23/10
INVOICE NO./ORDER NO.
I053397201047 06/23/10 UPS GROUND 06/23/10
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
4 4 100 -28985 02 EA DEWALT SAFETY GLASSES STRUCTURE CLEAR DPG93 -1 2.83 11.32
Purchase JUN 2 8 101
Descdpt)
P.O. P or F
ta►c�� B
G.L.
Budget
Line Descr
Purchaser Date
Approval Date
o e
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 3 PER SALES TAX SHIPPING HANDLING
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE
UNPAID BALANCE.
Payments must be payable in US dollars only
2% discount does not apply to credit card payments Thank You for Your Order!
FpnF:PAi ir)ld iR- 191ARIA
NORTHERN Remember.. We Always Offer INVOIdE
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.com Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID [CARMEL CLAY PARKS RECREATION
0004816021 1411 E 116TH ST
CARMEL, IN 46032
TOL CARMEL CLAY PARKS RECREATION
1411 E 116TH ST
CARMEL, IN 46032 L
101- 1125 4239012 06/21/10
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 07122110
INVOICE NO. /ORDER NO.
1053397201039 06/22/10 UPS GROUND 06/22/10
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
4 4 100 -28986 01 EA DEWALT SAFETY GLASSES STRUCTURE SMOKE DPG93 -2 3.47 13.88
TO,9 RJ
JUN 2 8 2010
Purc ase BY•
Desc iption
P.O. f P or F
G.L.
Budc et
Line escr
Purc aser Date
Appr val Date
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 02% PER SALES TAX SHIPPING HANDLING
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE
UNPAID BALANCE.
Payments must be payable in US dollars only
A discount does not apply to credit card payments Thank You for Your Order!
=r1CMAI ina 1a 104A01A
�RTHERN Remember... We Always Offer
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.com Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID CARMEL CLAY PARKS RECREATION
0004816021 1427 E. 116TH ST.
CARMEL, IN 46032
S OLD
OO: �ARMEL CLAY PARKS RECREATION
1411 E 116TH ST
CARMEL, IN 46032 L
1125 -420 -015- 4239000 06/18/10
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 07/18/10
INVOICE NO./ORDER NO.
1053344801014 06/18/10 UPS GROUND 06/18/10
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
6 6 252 -24786 01 BX UV SUN PROTECTION DISPENSER BX OF 50 TOWLETTES 30.89 185.34
p 9�
JUN 2 2010
Pumh
D motow BY
PA.f PorF
ML 4aj Qc)Q
Una Desd �4 l�G SUPPLIES
Pwahaw Dal9__.
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1' /z% PER SALES TAX SHIPPING HANDLING
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE 12
UNPAID BALANCE.
Payments must be payable in US dollars only
"2% discount does not apply to credit card payments Thank You f or Your O rder!
=rICDAI Jr I4 IQ InIA61A
�N ORTHERN Remember... We Always Offer mllmzs�
W 4 a 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• Fox: 800.635.1591 P.O. Box 4250
northernsafety.com Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID URMEL CLAY PARKS RECREATION
0004816021 1411 E 116TH ST
CARMEL, IN 46032
TOL CARMEL CLAY PARKS RECREATION
1411 E 116TH ST L
CARMEL, IN 46032
101- 1125 4239012 06/21/10
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE NOJORDER NO. INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 07/21/10
I053397201013 06/21/10 UPS GROUND 06/21/10
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
20 20 103 -19885 01 EA 2 -IN -1 EYEWEAR CASE 12 /PK NS MICRO 1.79 35.80
2 2 105 -3551 01 BX NORTHERN PRE MOISTENED LENS CLEANING TOWLETTES 8.08 16.16
1 1 100 -26490 01 EA OTS OVER THE GLASS CLEAR LENS S3510SJ 3.87 3.87
20 20 103 -22232 BK 01 EA ECONOMICAL EYEWEAR CORDS 12 /BG BLACK 0101 BILK .78 15.60
2 2 123 -26019 M 02 PR MECHANIX UTILITY GLOVE MEDIUM UTILITY GLOVE CG- 17.98 35.96
5 5 103 -3267 01 PR SLIP -ON SPEC- SHIELDS AT -7 1.01 5.05
2 2 123 -26019 XL 01 PR MECHANIX UTILITY GLOVE EXTRA LARGE 17.98 35.96
p urchase fl
D escription I!
.O.# PnrF 2 L5 ZQ�Q
M. L. i 1a5- �-a�5o1�
UCI et
ine Descr JAFuy C9 d pPU Es BYa
P urchaser Date
A pproval Date
SALES TAX SHIPPING HANDLING e
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1'12% PER 11.02 159.42
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE
UNPAID BALANCE.
Payments must be payable in US dollars only
2% discount does not apply to credit card payments Thank You for Your Order!
=rICQA1 lnu 1.
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
6123110 1053397201047 Safety glasses 12.16
6122110 1053397201039 Safety glasses 14.91
6118110 1053344801014 Misc. supplies 197.78
6121110 1053397201013 Safety glasses 159.42
Total 384.27
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
384.27
ON ACCOUNT OF APPROPRIATION FOR
101 General
PO# or INVOICE NO. ACCT #!TITLE AMOUNT Board Members
Dept
1125 1053397201047 4239012 12.16 1 hereby certify that the attached invoice(s), or
1125 1053397201039 4239012 14.91 bill(s) is (are) true and correct and that the
1125 1053344801014 4239000 197.78 materials or services itemized thereon for
1125 1053397201013 4239.012 1 which charge is made were ordered and
received except
15 -Jul 2010
Signature
384.27 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund