190885 10/13/2010 CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
6 ONE CIVIC SQUARE NORTHERN SAFETY CO, INC CHECK AMOUNT: $76.57
CARMEL, INDIANA 46032 PO BOX 4250
*4 pan �o UTICA NY 13504 CHECK NUMBER: 190885
CHECK DATE: 10/13/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4239012 105659830101 76.57 I056598301011
NORTHERN 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
north ernsa fety. com Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
PLEASE REFER TO YOUR YOUR CUSTOMER ID, OUR INVOICE AN D YOUR CUSTOMER ID CARMEL CLAY PARKS RECREATION
ORDER NO. IN ALL COMMUNICATIONS REGARDING THIS INVOICE 0004816021 1411 E 116TH ST
CARMEL, IN 46032
TOL CARMEL CLAY PARKS RECREATION
1411 E 116TH ST
CARMEL, IN 46032 L
1125- 410 4239012 09/27/10
YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED
INVOICE NO. /ORDER NO. PAYMENT DUE BY 10127110
I056598301011 09/27/10 UPS GROUND 09/27/10 4
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
1 121 -1736 S 01 PR STANZOIL KNITLINED NEOPRENE COATED GLOVE SMALL 6.00 6.00
1 121 -1736 M 01 PR STANZOIL KNITLINED NEOPRENE COATED GLOVE MEDIUM 6.00 6.00
2 T 123 -26019 XL 01 PR MECHANIX UTILITY GLOVE EXTRA LARGE 17.98 35.96
1 123 -26019 L 01 PR MECHANIX UTILITY GLOVE LARGE 17.98 17.98
Purchase
Des riptIon I SL LJ M L NT
P.O. or F
G.L.# —4a SDI o VIE
Bud et 5 0P19U E
Line escr Ff; OCT 0 12010
Purc haser Date
App val Date fill
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1 1 /2% PER SALES TAX SHIPPING HANDLING 76.57
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!
FEDERAL ID# 16-1214814
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
9/27/10 1056598301011 Safety supplies Maintenance Dept. 76.57
Total 76.57
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
76.57
ON ACCOUNT OF APPROPRIATION FOR
101 -General
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125 1056598301011 4239012 76.57 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
7 -Oct 2010
lzo
Signature
76.57 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund