155454 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 233701 Page 1 of 1
ONE CIVIC SQUARE ORR SAFETY CORP
s �I' CHECK AMOUNT: $195.18
CARMEL INDIANA 46032 1266 RELIABLE PARKWAY
«o CHICAGO IL 60686 CHECK NUMBER: 155454
CHECK DATE: 1110/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 960549 195.18 CONT SVS- OTHER -S PLAN
f.
i
Louisville, KY/ Indianapolis, IN/ Cincinnati, OH/ St. Louis, MO/
onsafety Charleston, WV/ Chicago, IL/ Kansas City, MO/ Fresno, CA
rt 7i ;5S'^1.'00dc4' Houston, TX/ Midland, MI
Bill To: Ship To:
CARMEL WASTEWATER TREAT PLT CARMEL WASTEWATER TREAT PLT
9609 HAZEL DELL PKWY 9609 HAZEL DELL PKWY
INDIANAPOLIS, IN 46280 INDIANAPOLIS, IN 46280
Invoice M INV4960549_
Invoice Date: 12114/2007
Page 1 of 1
PO Customer ID Master PackList Ship Method Payment Terms eCatalog
JEFFCOOPER 99611 1,561,643 OSO4369005 UPS GROUND NET 301AR
Ordered Shipped Back Orr Item Customer Item Orr Item Description Unit Ext.
Ordered Price Price
actory abor Da oz al
1 1 0 MILFLABOR $180.00 $180.00
S u btota 1 $180.00
Misc $0.00
Tax $0.00
Shipping $15.18
RETRACTABLE LIFELINE Amount Received $0.00
MODEL MR50G6
SERIAL# 33354 Total Due $195.18
For Orders Call 800 669 -1677 For Billing Inquiries Call 502- 774 -6557
Please Remit To: 1266 Reliable Parkway, Chicago, IL 60686
SAFETY SOLUTIONS PROFESSIONAL SERVICES PROTECTION SYSTEMS TECHNICAL SERVICES
An ISO -9001 Certified Corporation
VOL)CHER 077025 WARRANT ALLOWED
2'33701 IN SUM OF
QRR SAFETY CORP
.1<<:66 Reliable Parkway
'�hicago, IL 60686
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
960549 01- 7362 -06 $195.18
a
w
Voucher Total $195.18
Cost distribution ledger classification if
claim paid under vehicle highway fund
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
233701
ORR SAFETY CORP Purchase Order No.
1266 Reliable Parkway Terms
Chicago, IL 60686 Due Date 12/29/2007
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/29/200; 960549 $195.18
I hereby certify that the attached invoice(s), or bill(s) is (are) true and 5,
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer