164855 10/16/2008 CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
e ONE CIVIC SQUARE NORTHERN SAFETY CO, INC
CARMEL, INDIANA 46032 PO sox 4250 CHECK AMOUNT: $490.00
UTICA NY 13544
CHECK NUMBER: 164855
CHECK DATE: 10116/2008
DEPARTMENT ACCOU PO NUMBER INVOICE NUMBE AMOUNT DESCRIPTION
1046 4239012 421.64 SAFETY SUPPLIES
601 5023990.; 68.36. OTHER EXPENSES
a=
NDRTHERN Remember... We Always Offer II
Our Lowest Price When You Order. PLEASE REMIT TO:
PO Box 4250 Utica, NY 1 3504 -4250 100 Satisfaction Guaranteed! NORTHERN SAFETY CO., INC.
Phone: 600. 631 1246 Fox: 800.635. 1591 P.O. Box 4250
northernsafety.com Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID
PLEASE REFER TO YOUR YOUR OOR INVOICEAND',
ORDER NO. IN ALL COMMUNICATIONS REGARDING 0002411866
TO CITY OF CARMEL
ATTN UTILITIES DEPT
3450 W 131ST ST L
WESTFIELD, IN 46074
JERRY 09/18/08
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 10/18/08
INVOICE NO. /ORDER NO.
P223095000024 09/18/08 UPS GROUND 09/18/08 IF PAID BY 10/08/08 PAY" $67.21
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
1 1 190 -23481 01 EA 40 KEY CABINET 10 /CS TS821B 36.99 36.99
1 1 234 -4353 02 PK ACCIDENT PREVENT TAGS EMPTY CYLINDER DO NOT USE 20.36 20.36
SALES TAX SHIPPING HANDLING
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1 lb PER
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE G p
UNPAID BALANCE. 11.01 UU 36
Payments must be payable in US dollars only
2% discount floes not apply -to credit card payments Thank You for Your Order!
FFIIFRGI Ir11k 1R_171AA1A
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 10/6/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/6/2008 P2230950001 $68.36
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and 1 have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
VOUCHER 083230 WARRANT ALLOWED
—a
226500 IN SUM OF
NORTHERN SAFETY CO, INC
PO BOX 4250
UTICA, NY 13504 f)
OA
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
P2230950000 01- 6200 -03 $68.36
Voucher Total $68.36
Cost distribution ledger classification if
claim paid under vehicle highway fund
Remember... We Always Offer MUM
p M
Our Lowest Price When You Order.
PLEASE REMIT TO:
Saf and I ndustrial Supplies 100% Satisfaction Guaranteed! NORTHERN SAFETY CO., INC.
O Box 4250 Utica, NY 13504-4250 P.O. P Box 4250
q I V F
Phone. 800. 631 124.6 Fax: 800. 635. 1591 6 Utica, NY 13504 -4250
northernsafety.com SE X azo08
SHIP TO (IF OTHER THAN "SOLD TO
R CUSTOMER ID
PLEASE REFER
ARMFL CLAY PARK RECREATION
ORDER NO..IN ALL COMMUNICATIONS REGARDING THIS INVOICE,
0004816021 1235 CENTRAL PARK DR E
CARM V I[
TOL CARMEL CLAY PARKS RE 1 �1�,
1411 E 116TH ST F t F OCT 0 6 2008
CARMEL IN 46032 P.o.
o.L
Una Des" ��`z� 5 19 /15/08
L rch YOUR PURCHASE ORDER NUMBER AND DATE
Pu- OUR INVOICE DATE SH PPE DATE SHIPPED PAYMENT DUE BY 10/15/08
INVOICE NO.lORDER NO.
P222697101016 09/15/08 UPS GROUND 09/15/08 IF PAID BY 10/05/08 PAY $413.61
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
7 249 -24463 01 BX BAND -AID BRAND VARIETY PACK ASSORTED BX /280 13.84 96.88
4 249 -7243 01 BX STERILE PADS 4" X 4" 10 /BX 7226327 1.89 7.56
3 250 -22719 01 EA HURT -FREE ANTISEPTIC WASH 60Z 4459 5.25 15.75
6 250 -4350 01 BX TRIPLE ANTIBIOTIC OINTMENT 25 /BOX WJTA -1800 5.61 33.66
5 252 -26185 01 EA SPLINTER TWEEZERS WITH MAGNIFER 3.82 19.10
10 1 122 -24172 L 01 BX NS INDUSTRIAL POWDERED NITRILE GLV LARGE 7.79 77.90
2 2 250 -1802 01 BX ALCOHOL PREP PAD LARGE 100 /BOX 10 -3002 3.50 7.00
2 249 -5050 01 EA WATERPROOF ADHESIVE TAPE 1 /2 "X 10 YDS J &J 3.49 6.98
6 250 -4249 01 BX ANTISEPTIC TOWELETTE BACTERIAL WIPE IDOBX105201 2.88 17.28
1 1 252 -24784 01 PK TEMPA DOT DISPOSABLE ORAL THERMOMETER 10OCT 742 19.95 19.95
2 249 -7967 01 RL CO- LASTIC ELASTIC BANDAGES 215YD 4420 2.01 4.02
2 249 -8807 61 EA STERILE ROLLED GAUZE BANDAGE 27 2YDS STRETCH 2.63 5.26
11 1 250 24778 01 EA FIRST AID SPRAY HYDROGEN PEROXIDE HP2 -24 2.66 29.26
11 1 250 -24775 01 EA FIRST A1D'SPRAY ANTISEPTIC SPRAY AS2 -24 2.66 29.26
11 1 250 24780 01 EA FIRST AID SPRAY ITCH RELIEF AI2 -24 2.86 31.46
1 325 -01 CATALOG 01 EA NEW CUSTOMER CATALOG KIT NC071 .00
SALES TAX SHIPPING HANDLING TjpQn�pll�
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1 PER �1 QQ�� G
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE 20 A 421.
UNPAID BALANCE.
Payments must be Payable in US dollars only
2% discount does not apply to credit card payments T You for Your Order!
FFI'1FAG1 Ir1& iR_191dA9d
ACCOUNTS PAYABLE VOUCHED
a 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 I q 0 (C F
Purchase Order No. 4
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)) Amount
9115108 P222697101016 First Aid 421.64
Total 421.64
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
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
421.64
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1046 P2226971oio16 4239012 421.64 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
6 -Oct 2008
Signature
421.64 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund