191726 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 00350856 Page 1 of 1
ONE CIVIC SQUARE LEHIGH SAFETY SHOES
CARMEL, INDIANA 46032 PO BOX 371958 CHECK AMOUNT: $1,236.92
PITTSBURG PA 15250 -7958
CHECK NUMBER: 191726
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 509223 1,416.92 OTHER EXPENSES
651 5023990 788367 180.00 OTHER EXPENSES
POD It.
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Lehigh Outfitters, LLC Cust.No. Report Invoice Date Invoice#
39 East Canal Street
Nelsonville, Ohio 45764 085893 00000 00659 509223
Sold To: Ship To:
CARMEL WATER& WASTEWTR CARMEL WATER& WASTEWTR
TREATMENT PLANT TREATMENT PLANT
760 3RD AVE. SW 9609 HAZEL DELL PKWY
CARMEL IN 46032 INDIANAPOLIS, IN 46280
Customer's Order Number Mobile -Unit I Order Date Terms
027288 LH #5440 IND TRK 194 (SHTL) 1 10/29/1 0 30 DAYS NET
Sams employee Employee Dept Styr Siz Qty ul.: ivic ci ii j Saes 5 -Cis' Cor,pa,� Employee Pay—
Sli Id Name Pric Am Am Tax Fe Freigh Total Recv Subsid Bal Du Ded#
014756 avid turner G 1075 M 10 l 90.00 90.00 90.00 90.00
14757 'eff Cooper 5258 W 9 1 119.99 119.99 119.99 l 19.99
14758 'ason stweart R5007 W 11 1 116.00 116.00 1 16.00 I I b.00
14759 cordon kleinsmith 86074 M 10 1 104.99 104.99 104.99 104.99
14760 lene Patton G 1075 M I l 1 90.00 90.00 90.00 90.00
14762 etic robertson N 1303 M 9.5 1 124.99 124.99 124.99 124.99
14763 laine mallaber 65016 W 12 1 124.99 124.99 124.99 124.99
14765 gray latt R6004 W 10 1 94.99 94.99 94.99 94.99
014767 ml h mwell 65016 W II 1 124.99 124.99 124.99 124.99
14768 ete brennan 85007 W 9 1 116.00 116.00 116.00 116.00
14770 mike turner 5258 W 12 1 119-99 119.99 119.99 119.99
14772 hris stubbs G 1075 W I 1 1 90.00 90.00 90.00 90.00
14774 robbie kinkead C4814 W I l 1 99.99 99.99 99.99 9999
Total Qty Total Merchandise Adjustment Sales Tax Sery Fee Freight Cash Rec Company Subsidy Amount Due
13
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UTFI 1 1 E .com Call 1 -800- 444 -4086
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Lehigh Outfitters, LLC Cust.No. Report Credit Date Credit#
39 East Canal Street CREDIT MEMORANDUM 085893 00000 00659 1788367
Nelsonville, Ohio 45764
Sold To: Ship To:
CARMEL WATER& WASTEWTR CARMEL WATER& WASTEWTR
TREATMENT PLANT TREATMENT PLANT
760 3RD AVE. SW 9609 HAZEL DELL PKWY
CARMEL IN 46032 INDIANAPOLIS, IN 46280
Customer's Order Number Slsmn I Mobile Unit Order Date Terms
83 027288 LH #5440 IND TRK 194 (SHTL) 10/29/10 Credit
Line Ticket Employee Id Employee N—c Dept Other Credit Amount
Style WD Size Qty Price MDSE Amt Adjust Tax Sery Chg Misc Total Sale Cash Recvd Subsidy Emp Hal DED
1 014771 david tumer
61075 M 10 -1 90.00 -90.00 -90.00 -90.00
2 014775 lency patto❑
G1075 M I1 -1 90.00 -90 -00 90.00 40.00
Total Qty Merchandise Value Adjustment Tax Sery Chg Misc Cash Rec Subsidy Amount Due
_2 180.00 180.00 180.00
Original Credit Memo LE11Fot m7M-- 11Rl20107:33:18 AM- red0002)
VOYJCHER 106532 WARRANT ALLOWED
350856 IN SUM OF
LEHIGH SAFETY SHOES CO.
P.O. Box 371958
Pittsburgh, PA 15250
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Cade
509223 01- 7202 -05
509223 01- 7202 -06 90x94
Voucher Total
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 CARMEN
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
350856
LEHIGH SAFETY SHOES CO. Purchase Order No.
P.O. Box 371958 Terms
Pittsburgh, PA 15250 Due Date 11/512010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/5/2010 509223 $1,236.92
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