156275 02/06/2008 a CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
ONE CIVIC SQUARE NORTHERN SAFETY CO, INC
CARMEL, INDIANA 46032 PO BOX 4250 CHECK AMOUNT: $327.87
UTICA NY 13504 CHECK NUMBER: 156275
CHECK DATE: 2/6/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 02891790001 304.98 OTHER EXPENSES
601 5023990 02891790002 22.89 OTHER EXPENSES
D RTN /FRuv
Remember.. We Always Offer
Our Lowest Price When You Order. PLEASE REMIT TO:
Safety and Industrial Supplies 100% Satisfaction Guaranteed! NORTHERN SAFETY CO., INC.
PO Box 4250 Utica, NY 13504 -4250 P.O. Box Phone: 800. 631 1246 o Fax: 800.635. 1591 Utica, NY 135004 -4-
4250
northernsafety.com
SHIP TO (IF OTHER THAN 'SOLD TO')
YOUR ACCOUNT NO.
PLEASE REFER T O YOUR ACCOUNT INVO
O 0003217619
SOLD F
TO: CARMEL WATER DISTRIBUTION
3450 WEST 131ST STREET
WESTFIELD, IN 46074
01/21/08
L YOUR PURCHASE ORDER NUMBER AND DATE
INVOICE.NO NO_ INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 02/21/08
IO28917900021 01/22/08 UPS GROUND 01/22/08 If paid by2/11/2008 Deduct 2.00%
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
8 8 302 -6221 01 BX DURACELL AA INDUSTRIAL ALKALINE BATTERY 4 /BX 2.63 21.04
o�Q nC(IIQ
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1 PER SALES TAX SHIPPING HANDLING
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE
UNPAID BALANCE. 1 lq� 22 P19
Payments must be payable-in US.dollars only
2% discount does not apply to credit card payments
FEDERAL ID# 16- 1214814
Please return bottom portion with payment.
'C
g j 00 u_ u u u E 0 1 Remember.. We Always Offer MOM
Our Lowest Price When You Order. PLEASE REMIT TO:
Safety and Industrial Supplies 100% Satisfaction Guaranteed! NORTHERN SAFETY CO., INC.
P.O. Box 4250
PO Box 4250 Utica, NY 13504 -4250
Phone: 800.631 1246 Fax: 800.635. 1591 Utica, NY 13504 4250
northernsafety.com
SHIP TO (IF OTHER THAN 'SOLD TO
YOUR ACCOUNT NO.
OUR
0003217619
SOLD F
T O: CARMEL WATER DISTRIBUTION
3450 WEST 131ST STREET
WESTFIELD, IN 46074
01/21/08
L YOUR PURCHASE ORDER NUMBER AND DATE
INVOICE DATE SHIPPED VIA DATE SHIPPED
INV -oicE NO/OROER ryo._ PAYMENT DUE BY 0
IO28917900013 01/21/08 UPS GROUND 01/21/08 1 If paid b 02/10/08 Deduct 2.00°/%
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
1 1 107 -20124 01 EA NS RATCHET HEADGEAR SF -103 5.25 5.25
2 2 121 -24178 XL 01 PR NS NEOPRENE OUTDOOR GLOVE EXTRA LARGE6PAIR /PKG 7.99 15.98
8 8 302 -6211 01 BX DURACELL D -CELL INDUSTRIL ALKALINE 12 /BX 1300 14.69 117.52
1 1 302 -6215 01 BX DURACELL 9 VOLT INDUSTRIAL ALKALINE 12 /BX 1604 29.15 29.15
8 8 302 -6213 01 BX DURACELL C -CELL INDUSTRIAL ALKALINE 12 /BX 1400 14.05 112.40
1 1 325 -01 CATALOG 01 EA NEW CUSTOMER CATALOG KIT NC071 .00
SALES TAX SHIPPING HANDLING 0
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1 1 /2% PER
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE
UNPAID BALANCE. 24. 6J 304 98
vments must be payable-in US dollars only
oes not apply to credit card payments
Ir, FEDERAL ID# 16- 1214814
with payment:
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 t
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 1/28/2008
Invoice Invoice Description
Date Number (or note attached invoices) or bill(s)) Amount
1/28/2008 0289179000: $22.89
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
,z
Date Officer
ci
VOUCHER 074544 WARRANT ALLOWED
226500 IN SUM OF
NORTHERN SAFETY CO, INC
x, PO BOX 42501
UTICA, NY 13504 0
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
02891790002 01- 6200 -06 $22.89
r:
Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund