188451 08/03/2010 a CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
ONE CIVIC SQUARE NORTHERN SAFETY CO, INC
CHECK AMOUNT: $166.89
CARMEL, INDIANA 46032 Po aox 4250
UTICA NY 13504 CHECK NUMBER: 188451
CHECK DATE: 8/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 27561440101 65.85 MATERIALS SUPPLIES
1125 4239012 53857201016 101.04 SAFETY SUPPLIES
iN OR.THERN Remember... We Always Offer
=Z2MjN==W 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 .12A6 Fax: 800.635. 1591 P.O. Box 4250
northernsafety.com Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID rCARMEL CLAY PARKS RECREATION
0004816021 1411 E 116TH ST
CARMEL, IN 46032
SOLD
TO: f CARMEL CLAY PARKS RECREATION
1411 E 116TH ST
CARMEL, IN 46032
101 1125 4239012 07/06/10
.Bya
YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE OJORDER NO. INVOICE DATE SHIPPED VIA DATE SNIPPED PAYMENT DUE BY 08/05/10-
I053857201016 07/06/10 UPS GROUND 07/06/10
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
1 1 165 -3550 01 EA DBI /SALA 5000LB TIEOFF STRAP ANCHOR PT1003000 41.04 41.04
1 1 165 -10061 01 EA TITAN LANYARDS W/2 LOCKING SNAP HOOKS T5111 48.63 48.63
Purchase
Description
P.O.# PorF
ue Desar c, N fEly UPLLAE6
Purchaser Date
Approval Date
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1' /2% PER SALES TAX SHIPPING 8 HANDLING
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE 11.37 101.04
UNPAID BALANCE.
Payments must be- payable in US dollars only
2% discount does not apply to credit card payments Thank You for Your Order!
FFnFRAI Ifl# iF- 191dR1d
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
7!6110 1053857201016 Safety supplies 101.04
Total 101.04
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
1 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
101.04
ON ACCOUNT OF APPROPRIATION FOR
101 General
PO# or INVOICE NO. ACCT #MTLE AMOUNT Board Members
Dept
1125 1053857201016 4239012 101.04 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
29-Jul 2010
Signature
101.04 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
ORT HERN 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 Fox: 800.635.1591 P.O. Box 4250
northernsafety.com Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID rBRIAN
0002411866 CITY OF CARMEL
UTILITIES DEPT
SOLD 3450 W 131ST ST
TO: CITY OF CARMEL CARMEL, IN 46074
ATTN UTILITIES DEPT
3450 W 131ST ST
CARMEL, IN 46074
TIM 07112110
L YOUR PURCHASE ORDER NUMBER AND DATE
INVOICE 0 NO. INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 08/11/10
P275614401018 07112110 UPS GROUND 07/12/10 IF PAID BY 08/01/10 PAY $64.75
ORDERED SHIPPED ITEM NO, UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
1 1 117 -29449 01 8X EAR1110 FOAM PLUGS CORDED 100 /13X 70070406312 22.99 22.99
4 4 118 -600E 01 EA CABOFLEX HEARING PROTECTOR NRR 20 320 -2001 7.98 31.92
SALES TAX SHIPPING HANDLING
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1 /z% PER 10.94 65.85
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 Th ank You for Your Order!
FEDERAL ID# 16- 1214814
VOUCHER 102255 WARRANT ALLOWED
226500 IN SUM OF
NORTHERN SAFETY CO, INC
PO BOX 4250
UTICA, NY 13504
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
275614401 o1 01- 6200 -00 $65.85
Voucher Total $65.85
Cost 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 7/27/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/27/2010 2756144010' $65.85
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