189448 08/31/2010 CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
ONE CIVIC SQUARE NORTHERN SAFETY CO, INC
CARMEL, INDIANA 46032 PO Box 4250
CHECK AMOUNT: $137.32
UTICA NY 13504
CHECK NUMBER: 189448
CHECK DATE: 8131/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4239012 055087701012 49.80 SAFETY SUPPLIES
601 5023990 27915190101 87.52 OTHER EXPENSES
b:,
N ORTHERN Remember.. We Always Offer
Our Lowest Price When You Order.
PLEASE REMIT TO:
PO Box 4250 Ulna, NY 13504-4250 100% Satisfaction Guaranteed! 0RRTHERN 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 �ARMEL CLAY PARKS RECREATION
0004816021 1411 E 116TH ST
CARMEL, IN 46032
TOL �CARMEL CLAY PARKS RECREATION
1411 E 116TH ST
CARMEL, IN 46032
1125- 410 4239012 08/10/10
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE OJORDER NO. INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 09/09/10
I055087701012 08/10/10 UPS GROUND 08/10/10
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
5 5 105 -3551 06 BX NORTHERN PRE MOISTENED LENS CLEANING TOWLETTES 7.68 38.40
Purchase
Description r
P.Q. P or F 519
G.L.0 AE 1 6
Budget
Une Desor
Purchaser Date o
Approval Date
SHIPPIN
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 17,% PER SALES TAX G 8 HANDLING
p
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18 J TO BE APPLIED TO THE 11 4O 49 8O
UNPAID BALANCE.
Payments must be payable in US dollars only
2% discount does not apply to credit card payments Thank YOU for Yours
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
8110110 1055087701012 Lens cleaners 49.80
Total 49.80
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$
49.80
ON ACCOUNT OF APPROPRIATION FOR
101 General
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 1055087701012 4239012 49.80 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
26 -Aug 2010
Signature
49.80 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
AJ ORTHERN Reme,be... We Always Offer
Our Lowest Price When You Order,
PLEASE REMIT T0:
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
north ernsa fety. com Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID �ITY OF CARMEL
PLEASE REFER T O INVO
R 0002411866 5484 EAST 126TH ST
CARMEL, IN 46033
TO- CITY OF CARMEL
ATTN UTILITIES DEPT
3450 W 131ST ST L
WESTFIELD, IN 46074
ANDY 08/18/10
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 09/17/10
INVOICE NO. /ORDER NO.
P279151901018 08/18/10 UPS GROUND 08/18/10 IF PAID BY 09/07/10 PAY $86.00
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
1 1 145 -26328 10 02 PR SKECHERS MENS STEEL TOE SPORT SNEAKERSZ10 76770 75.95 75.95
1 L 325 -01 CATALOG 02 EA NEW CUSTOMER CATALOG KIT NC071 .00
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
UNPAID BALANCE.
Payments must be payable in US dollars only
2% discount does not apply to credit Card payments Prank You for Your Order!
FEDERAL ID# 16- 1214814
VOUCHER 102526 a WARRANT ALLOWED
226500 IN SUM OF
NORTHERN SAFETY CO, INC
PO BOX 4250
UTICA, NY 13504
0
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
27915190101 01- 6200 -03 $87.52
Voucher Total $87.52
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 8/24/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/24/2010 2791519010' $87.52
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