157654 03/19/2008 f CITY OF CARMEL, INDIANA VENDOR: 276575 Page 1 of 1
ONE CIVIC SQUARE SAFETY SOLUTIONS, INC
CARMEL, INDIANA 46032 PO BOX 8100 CHECK AMOUNT: $240.00
DUBLIN OH 46016 -2100 CHECK NUMBER: 157654
CHECK DATE: 3/19/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 01254182 120.00 OTHER EXPENSES
651 5023990 1254907 120.00 OTHER EXPENSES
i
6161 Shamrock Ct.• P.O. Box 8100
Dublin, OH 43016 -2100
INCORPORATED 800.232.7463 (fax)614.799.9901 x .'I'nYOIC�e 01254182
Regional Offices Distribution Centers Pa
Birmingham, AL Mobile, AL Columbus, OH Toledo, OH
866.241.9399 888.871.7463 800.232.7463 419.360.9900
Date r 02/21/2008
Pittsburgh, PA Syracuse, NY Auburn, IN
800.562.0555 800.836.7463 260.927.1956 n
03/07/2008
129700 Ship To: 1
City Of Carmel City of Carmel
Water Distibution Sewer Department
130 1st Ave. S.w., Ste. B 760 3rd Ave. SW, Suite 110
Carmel, IN 46032 Carmel, IN 46032
Customer RO Number Release No Salesperson a Whse 4k Ship Date Document
AARON Jason Barzak 01 0212112008 01305342
Terms Tax Code Freight `f Ship -Ula
Net 15 IN15 Prepaid Fedex Ground
Item Number Descrlptton Or
Shipped A Backorder UM Pnce X Pei Eztenston
_'d''' 6s -i, a:+�Z
0100000669680130 1 1 0 PR 120.00 PR 120.00
6696 ROCKY SZ: 13W
DARRELL
Taxes:
INDIANA 7
Remit To: Safety olutions, Inc
y MerchandtsesS H �(Ta Payments t� aTota! Due
PO Box 8100
Dublin, OH 43016 -2100 120.00 0.00 7.2 1 .20
VOUCHER 085072 WARRANT ALLOWED
276575 IN SUM OF
S1FETY SOLUTIONS, INC
PO BOX 8100
'DUBLIN, OH 46016 -2100
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
01254182 01- 7200 -01 $120.00
Voucher Total $120.00
Cost distribution ledger classification if
Q�aim 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 j
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
276575
SAFETY SOLUTIONS, INC Purchase Order No.
PO BOX 8100 Terms i
DUBLIN, OH 46016 -2100 Due Date 3/13/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/13/2008 01254182 $120.00
i
i
i
i
certify that the attached invoice(s), or bills is (are) true and
hereby fy O
orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
S/ YZ
Date Officer
6161 Shamrock Ct.• P.O. Box 8100
a l
d I Dublin, OH 43016 -2100 01254907
INCORPORATED 800.232.7463 (fax)614.799.9901�`
Regional Offices 8 Distribution Centers Pa e
Birmingham, AL Mobile, AL Columbus, OH Toledo, OH -r g
866.241.9399 888.871.7463 800.232.7463 419.380.9900
Pittsburgh, PA Syracuse, NY Auburn, IN "Date k f Q2/22/2008
C
800.562.0555 800.836.7463 260.9271956
Due Date w5_ 03/08/2008
g
Sold To 129700 Ship To: 1
City Of Carmel City of Carmel
Water Distibution Sewer Department
130 1 st Ave. S.w., Ste. B 760 3rd Ave. SW, Suite 110
Carmel, IN 46032 Carmel, IN 46032-
Ciistomer''PO Number Release No. Salesperson s x Whse Shlp Date Document
x
AARON Jason Barzak 01 02/22/2008 01305666
Terms Tax Code Freight Shlp`Vla
,1:, YS:3. j" v. e...� i L .W. _t:� �:s.. ".i .£A.fi ..`r5 <iL.i., ➢V k,
Net 15 IN15 Prepaid Fedex Ground
k3"5r,.4� rz b?'
Item N Descnptlon Ordered ,x Shipped Backorder UMWPnce Per s Extension r=
-i��..
0100000669650105 1 1 0 PR 120.00 PR 120.00
6696 ROCKY SZ: 10.5M
RANDY
Shipping warehouse: 90
Taxes:
INDIANA 7.20
Remit To: Safety Solutions Inc. MerchandiseF =,5 &Ha y `Payments Total�Due
PO Box 8100:
Dublin, OH 43016 -2100 120.00 0.00 7.20 .20
l�D,bb
VOUCHER 085034 WARRANT ALLOWED
x
276575 IN SUM OF
SAFETY SOLUTIONS, INC
PO BOX 8100
DUBLIN, OH 46016 -2100
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
1254907 01- 7200 -01 $120.00
Voucher Total $120.00
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
276575
SAFETY SOLUTIONS, INC Purchase Order No.
PO BOX 8100 Terms
DUBLIN, OH 46016 -2100 Due Date 3/10/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/10/2008 1254907 $120.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
,orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer