192507 12/07/2010 CITY OF CARMEL, INDIANA VENDOR: 205250 Page 1 of 1
ONE CIVIC SQUARE MINE SAFETY APPLIANCES CO CHECK AMOUNT: $2,116.14
CARMEL, INDIANA 46032 PO BOX 640348
PITTSBURGH PA 15264 -0346 CHECK NUMBER: 192507
CHECK DATE: 121712010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4467003 27020 94910274 2,116.14 BALLISTIC VESTS
The Safety Company
Mine Safety Appliances Company
PO Box 426
Pittsburgh, PA 15230 -0426
D -U -N -S 00- 432 -1865
FEI 25- 0668780
Invoice
Sold To: Invoice No.: 94910274
IiInlillnllnniiiiillilligilI Invoice Date: 15 Nov 2010
CARMEL POLICE DEPT Customer No.: 520000
3 CIVIC SQUARE Order No.: 3592657
CARMEL IN 46032 Delivery No.: 87044237
P.O. Date: 03 Sep 2010
Customer P.O. No.: 27020
Ship To:
CARMEL POLICE DEPT
ATTN MAJOR JIM BARLOW
3 CIVIC SQUARE
CARMEL IN 46032
Your Contact Person: Customer Service
Telephone No.: 866 672 -1001 Fax No.: 800 967 -0398 PAGE 1 1
Date Shipped Shipped via Bill of lading No. Terms of Shipment Terms of Payment
15 Nov 2010 UPS UNITED PARCEL SERVI FOB DEST /FA NET 30 DAYS
Item Qty UM Mat No. Description Unit Price Net Price
EFTA Batch Qty
70 6 EA 10060484 352.69 2,1 16.14
HELMET ASSY,COML ACH,MD,BK,O NVG,PAD 6
Country of Origin: FR Commodity Code: 6506.10.6045
Shipping Info:
UPS UNITED PARCEL SERVI
Remit Payment to: Ordered By: TERESA ANDERSON SubTotal: 2,116.14
Mine Safety Appliances Co. Telephone: 317 -571 -2559
P.O. Box 640348 Total USD: 2,116.14
Pittsburgh, PA. 15264 -0348
Fax: 412- 967 -3087
THERE IS A SERVICE CHARGE OF
1.25% ON ALL ITEMS PAST DUE
THANK YOU FOR YOUR ORDER
VOUCHER NO. WARRANT NO.
ALLOWED 20
Mine Safety Appliances Company
IN SUM OF
P.O. Box 426
Pittsburgh, PA 15230 -0426
$2,116.14
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
27020 94910274 44- 670.03 $2,116.14 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
Friday, December 03, 2010
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor 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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11/15/10 94910274 helmets $2,116.14
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
20
Clerk- Treasurer