HomeMy WebLinkAbout197321 05/11/2011 CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
ONE CIVIC SQUARE NORTHERN SAFETY CO, INC CHECK AMOUNT: $538.55
CARMEL, INDIANA 46032 Po Box 4250
i? UTICA NY 13504
CHECK NUMBER: 197321
CHECK DATE: 5/11/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT D
1091 4239012 0004816021 538.55 I063401301022
�N ORTHERN Remember... We Always Offer
mm" g rvmgn Our Lowest Price When You Order. PLEASE REMIT T0:
PO Box 4250 Utica, NY 13504 100% Satisfaction Guaranteed! NORTHERN SAFETY CO., INC.
Phone: 800. 631 1246 Fax: 800. 635. 1541 P.O. Box 4250
northernsafety.com Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID
CARMEL CLAY PARKS RECREATION
0004816021 1411 E 116TH ST
CARMEL, IN 46032
SOLD
TO: CARMEL CLAY PARKS RECREATION
1411 E 116TH ST L
CARMEL, IN 46032
28409 04/18/11
L YOUR PURCHASE ORDER NUMBER AND DATE
O U R INVOICE NO./ NO. INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 05/18/11
1063401301022 04/18/11 UPS GROUND 04/18/11
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
10 1 150 -4255 01 BX 3M 8577 P95 PARTIC RESP W /EXHAL VLVE 8577 41.18 411.80
4 153 -3959 01 PR NORTH P100 PARTIC CART 758OP100 8.65 34.60
4 156 -7019 02 EA RESPIR STORG BG 14 "X16" W /ZIPPPER 4.03 16.12
1 156 -7007 01 BX RESPIR WIPE PADS NO ALCOHOL10013X 13.15 13.15
2 110 -28896 25 01 EA NS INFUSION READERS MAGNIFICATION 2.5 8 -95 17.90
1 152 -7700 S 01 EA HALF MASK SILICONE RESPIR 7700 -30 SM 26.96 26.96
Purchase
Description -%r PPL)E5
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urchaser Date
proval at
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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 18.0 538.55
UNPAID BALANCE.
Payments must be payable in US dollars -only
2% discount does not apply to credit card payments Thank You for Yo u r Order!
FEDERAL ID# 16- 121
I
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
4/18111 1063401301022 Safety supplies 28409 538.55
Total 538.55
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
1 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
538.55
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1091 1063401301022 4239012 538.55 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
4 -May 2011
Signature
538.55 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund