191767 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
ONE CIVIC SQUARE NORTHERN SAFETY CO, INC
CHECK AMOUNT: $76.69
CARMEL, INDIANA 46032 Po eox 4250
UTICA NY 13504 CHECK NUMBER: 191767
CHECK DATE: 11110/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
604 5023990 28448490101 76.69 OTHER EXPENSES
LIORTHERN Remember'... We Always Offer f
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
northernsafety. com
Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID CITY OF CARMEL
PLEASE REFER TO YOUR CUSTOMER 10, s OUR INVOICE AND. 0002411866 5484 EAST 126TH ST
CARMEL, IN 46033
SOLD CITY OF CARMEL
ATTN UTILITIES DEPT
3450 W 131ST ST
WESTFIELD, IN 46074
PORT GENERATOR 10/22/10
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE OJORDER NO, INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 11/21/10
P284484901016 10122110 UPS GROUND 10/22/10 IF PAID BY 11/11/10 PAY $76.69
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
6 5 225 -7079 01 EA TRAFFIC CONE 18" SLIM TRIM 3 LBS 3004034 8.86 53.16
SALES TAX SHIPPING HANDLING
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1 PER 7
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE 24.5 7.75
UNPAID BALANCE.
VOUCHER 103231 WARRANT ALLOWED
226500 IN SUM OF
NORTHERN SAFETY CO, INCA
PO., BOX 4250
UTICA, NY 13504
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
oa: SD �za
28448490101 02- 2308 -00 $76.69
Depreciation
I
Voucher Total $76.69
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 C:ARMEL
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 11/3/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/3/2010 2844849010' $76.69
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 f6ff