165361 10/29/2008 \�f CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
3I ONE CIVIC SQUARE NORTHERN SAFETY CO, INC CHECK AMOUNT: $758.53
CARMEL, INDIANA 46032 PO BOX 4250
UTICA NY 13504 CHECK NUMBER: .165361
CHECK DATE: 10/29/2008
DEPARTMENT ACCOUNT P O NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4356003 P2251447 758.53 SAFETY ACCESSORIES
NORTHERN Remember... We Always Offer
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: 600. 635. 1591 P.Q. Box 4250
north ernsafety.Com Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID
*PLEASE REFER TO YOUR YOUR OUR AND 1
a
SOLD FCARMEL FIRE DEPARTMENT
TO: 2 CIVIC SQUARE
CARMEL, IN 46032 L
GARY 10/09/08
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 11/08/08
INVOICE- NOJORDER_NO._
P225144700017 10/09/08 UPS GROUND 10/09/08 IF PAID BY 10/29/08 PAY $743.76
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
12 12 123 -1665 S 01 PR GRAIN LEA DRIVERS GLV KEYSTONE THUMB SM GRN /RED 5.59 67.08
12 12 123 -1665 M 01 PR GRAIN LEA DRIVERS GLV KEYSTONE THUMB MED GREEN 5.59 67.08
60 60 123 -1665 L 01 PR GRAIN LEA DRIVERS GLV KEYSTONE THUMB LG BROWN 5.59 335.40
36 36 123 -1665 XL 01 PR GRAIN LEA DRIVERS GLV KEYSTONE THUMB XL BLUE 5.59 201.24
1 1 247 -3211 SZ 2XL 01 DZ GRAIN LEATHER DRIVERS GLOVE SZ 2XL 3211 SZ 2XL 67.60 67.60
1 1 SP2008CAT 01 EA 2008 CATALOG BC082 .00
SALES TAX SHIPPING HANDLING
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF i' /z PER
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE _20 ._1._ 75B. 53
UNPAID BALANCE.
Payments must be Payable in US dollars only
2% discount does not apply to credit card payments Thank You for Your Order!
FFIIFRBI iflf! iR_1'JidSEi
f
4'.i
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))
P2251447 Gloves $758.53
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
2a
Clerk- Treasurer
VOUCHER NO. !WARRANT NO.
ALLOWED 20
No! Safety
IN SUM OF
F.O. Box 4250
Utica, NY 13504
$758.53
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# 1 Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
1120 P2251447 43- 560.03 $758.53 I 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
0 2 T 2i
0 r'. �---0
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund