166327 11/24/2008 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: $126.41
UTICA NY 13504 CHECK NUMBER: 166327
CHECK DATE: 11/24/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 22707330001 126.41 OTHER EXPENSES
L'
TUU E00I `J Remember... We Always Off er 0W @M
=92 0 W 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 a 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 CUSTOMER ID
PLEASE REFER T YOUR YOUR O UR INVOICE AND
ORDER NO. IN ALL COMMUNICATIONS REGARDING THIS INVOICE 0002411866
SOLD
TO: CITY OF CARMEL
ATTN UTILITIES DEPT
3450 W 131ST ST L-
WESTFIELD, IN 46074
KRIS 10/29/08
L YOUR PURCHASE ORDER NUMBER AND DATE
INVOICE- NO�lORDER_NO. INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 11/28/08
P227073300017 10/29/08 UPS GROUND 10/29/08 IF PAID BY 11/18/08 PAY $124.27
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
7 109 -5416 01 EA EYEWASH /SKIN NEUTRALIZER STATION 160Z BOTTLE 15.32 107.24
1 1 325 -01 CATALOG 01 EA NEW CUSTOMER CATALOG KIT NC071 .00
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
UNPAID BALANCE. 19.1 126.41
Payments must be payable in US dollars only
2% discount does not apply to credit card payments Thank You for Your Order!
FFnFRAI 11)# iR- 1914A14
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 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 11/18/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/1 2270733000' $126.41
2
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
VOUCHER 083694 WARRANT ALLOWED
226500 IN SUM OF
'NORTHERN SAFETY CO, IN
PO BOX 4250
UTICA, NY 13504
r
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
22707330001 01- 6200 -03 $126.41
Voucher Total $126.41
Cost distribution ledger classification if
claim paid under vehicle highway fund