188457 08/03/2010 CITY OF CARMEL, INDIANA VENDOR: 233701 Page 1 of 1
0 ONE CIVIC SQUARE ORR SAFETY CORP CHECK AMOUNT: $425.00
CARMEL, INDIANA 46032 1266 RELIABLE PARKWAY
CHICAGO IL 60686 CHECK NUMBER: 188457
CHECK DATE: 8/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1647663 425.00 CONT SVS- OTHER -S PLAN
Louisville, KY/ Indianapolis, IN/ Cincinnati, OH/ Houston, TX
Charleston, WV/ Chicago, IL/ Kansas City, MO/ Fresno, CA
Sherwood Park, Alberta
Bill To: Ship To:
CARMEL WASTEWATER TREAT PLT CARMEL WASTEWATER TREAT PLT
760 THIRD AV SW JEFF COOPER
CARMEL, IN 46032 9609 HAZEL DELL PKWY
INDIANAPOLIS, IN 46280
Invoice INV1647663
Invoice Date: 07/12/2010
Page 1 of 1
PO Customer ID Master PackList Ship Method Payment Terms eCatalog
11937 4015589 2,333,515 OSC NET 30 AR
Ordered Shipped Back Ordered Orr Item Customer Item Orr Item Description Unit Ext.
Price Price
5 5 0 LBRLVICR C R ice Labor Instrumentation $85.00 $425.00
Su btotal $425.00
Misc $0.00
Tax $0.00
Shipping $0.00
Calibration of LEL (CH4) monitors. Amount Received $0.00
Reference RA# 324700.
Total Due $425.00
For Orders Call 800- 669 -1677 For Billing Inquiries Call 502- 774 -6557
Please Remit To: 1266 Reliable Parkway, Chicago, IL 60686
SAFETY SOLUTIONS PROFESSIONAL SERVICES PROTECTION SYSTEMS TECHNICAL SERVICES
An ISO -9009 Certified Corporation
,VOUCHER 105905 WARRANT ALLOWED
+233701 IN SUM OF
ORR SAFETY CORP
1266 Reliable Parkway
Chicago, IL 60686
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
1647663 01- 7362 -06 $425.00
P 7
Voucher Total $425 -00
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 Cr
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
233701
ORR SAFETY CORP Purchase Order No.
1266 Reliable Parkway Terms
Chicago, IL 60686 Due Date 7/27/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/27/2010 1647663 $425.00
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
1
Date Officer.