163276 09/03/2008 CITY OF CARMEL, INDIANA VENDOR: 179310 Page 1 of 1
ONE CIVIC SQUARE LAB SAFETY SUPPLY INC CHECK AMOUNT: $149.12
CARMEL, INDIANA 46032 Po Box 5004
JANESVILLE WI 53547 -5004 CHECK NUMBER: 163276
CHECK DATE: 9/3/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1011996467 93.56 MATERIALS SUPPLIES
1192 4239012 1012031774 55.56 SAFETY SUPPLIES
i
Order 13v Phone: 1- 800 -356 -0783 L.ah SatahV Suppl} Inc.
OrderC ?aline_ wwu�_LSS.com FEI N 39-1726218
GST` 8940974761ZT
SM Order 131' FIN: 1 -800- 543 -9910 401 S. Wriglil Rd- 1 13os 1368
Technical Supporl: 1 -800- 356 -2501 Janesville WI U S.A. 53547 -1368
LAB SAFETY SUPPLY
PO Ros 1368
Janesville, NNII USA 53547-1368 City of Carmel
ORIGINAL INVOICE
Dept. of Community services
003455 PAGE 1 OF 1
?B= CITY OF CARMEL 5! CITY OF CARMEL
Is Hl
ATTN: BUILDING AND CODE SERVICES ATTN: BUILDING AND CODE SERVICES
1 CIVIC SQ 1 CIVIC SQ
I CARMEL IN 46032 -2584 7 CARMEL IN 46032 -2584
j O
order Nc> P :iEVo Sold',; Ta .Na> lrwo e Na Inuorce Cate Due Ug
SCO3637073 WEDDINGTON08202008 5208827 1 1012031774 08/21/2008 09/20/2008
!Buy$r
arrrer l refight Terms. .$Ellis. bate P,a}rrneRt :Terms
WEDDINGTON,TRUDY UPSGND LOCKED 08/21/2008 Net 30
>INEROEJUCT 1V� QCRIR Et)I E 4. Q W U C? IVI A1V60UNT AMOUNT
1 9811 VST TRFC UNVRSL OR PLYSTR AN 0 8.00 EA 5.80 46.40
SUBTOTAL: 46.40
Thank you for your order. FREIGHT: 9.16
TAXES: 0.00
PAYMENT TERMS-. Net 30 TOTAL AMOUNT DUE BY 09/20/2008 55.56 USD
ORIGINAL
After 90 days from invoice date, Lab Safety Supply, Inc. wiil not be responsible to show proof of delivery.
TITLE TO ALL MERCHANDISE SHIPPED PASSES TO THE PURCHASER UPON DELIVERY TO THE COMMON CARRIER.
NO CLAIMS, DEDUCTIONS OR RETURNS ACCEPTED WITHOUT OUR WRITTEN CONSENT. ALL CLAIMS MUST BE MADE
WITHIN 15 DAYS AFTER RECEIPT OF GOODS. ALL PRICES SUBJECT TO CHANGE WITHOUT NOTICE; PRICES
PREVAILING ON TIME OF DELIVERY. THE GOODS COVERED BY THIS INVOICE WERE PRODUCED IN COMPLIANCE
WITH THE REQUIREMENTS OF THE FAIR LABOR STANDARDS ACT OF 1938, AS AMENDED.
THESE COMMODITIES ARE LICENSED FOR THE ULTIMATE DESTINATION SHOWN. DIVERSION CONTRARY TO THE
UNITED STATES LAW IS PROHIBITED. CUSTOMER HEREBY UNCONDITIONALLY AND WITHOUT RESERVATION AGREES
THAT LAB SAFETY SUPPLY, INC. IS ENTITLED TO ENFORCE THE TERMS OF THIS SHIPPING ORDER UNDER THE LAWS
OF THE STATE OF WISCONSIN AND IN A WISCONSIN FORUM.
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.
/CL4b Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
a� /01X) 3/ r 5
Total
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 -1.5.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
Po 500 1 1
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
10Q 3 T)y 394 .1 S�_� 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
20d
�Signat e
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
order By I'liotic: 1-800-336-0753 Lab SA'etv Stipple Inc.
Order 01flille: %vw%v.l_ss.colll 39-1726218
m Order By Fax: 1 -500-543-991 0 (IsT, 8940974761ZT
401 S. Wi ght Rd. 1 Box 1368
_l'eCh1llCll SLIPPOW 1- 800 356 -2 Janesville NVI LI-S-A. 53547-1368
LAB SAFETY SUPPLY
P0 Box 1368
Jaiiesvville, XVI USA 53547-1368
003468 PAGE I OF 1
i t: CITY OF CARMEL CITY OF CARMEL
ACCOUNTS PAYABLE 3450 W 131ST ST
3450 W 131ST ST WESTFIELD IN 46074-8267
,4, WESTFIELD IN 46074-8267
;::;;:P.; ::No�,L:::::,::::::
er,::T 0;1 1?ue :Date
SCO3604656 METERSHOP 6078343 1 1011996467 08/14/2008 09/13/2008
P T
BUCKSOT,BRUCE UPSGND LOCKED 08/14/2008 Net 30
Q T Y
NIT
!i�: :Q-T. Y.�
L
'OU T-��:�]
'J\A m
SHI P A -A
PRODUCT DESCR, IPT MOV
NT
1 58242 HAND CLNR MULTI-GREEN 2000 M 0 4.00 EA 19.90 79.60
SUBTOTAL: 79.60
Thank you for your order. FREIGHT: 13.96
TAXES: 0.00
PAYMENT TERMS: Net 30 TOTAL AMOUNT DUE BY 09/13/2008 93-561 USD
ORIGINAL
After 90 days from invoice date, Lab Safety Supply, Inc. will not be responsible to show proof of delivery.
i
TITLE TO ALL MERCHANDISE SHIPPED PASSES TO THE PURCHASER UPON DELIVERY TO THE COMMON CARRIER.
NO CLAIMS, DEDUCTIONS OR RETURNS ACCEPTED WITHOUT OUR WRITTEN CONSENT, ALL CLAIMS MUST BE MADE
WITHIN 15 DAYS AFTER RECEIPT OF GOODS. ALL PRICES SUBJECT TO CHANGE WITHOUT NOTICE; PRICES
PREVAILING ON TIME OF DELIVERY. THE GOODS COVERED BY THIS INVOICE WERE PRODUCED IN COMPLIANCE
WITH THE REQUIREMENTS OF THE FAIR LABOR STANDARDS ACT OF 1938, AS AMENDED.
THESE COMMODITIES ARE LICENSED FOR THE ULTIMATE DESTINATION SHOWN. DIVERSION CONTRARY TO THE
UNITED STATES LAW IS PROHIBITED. CUSTOMER HEREBY UNCONDITIONALLY AND WITHOUT RESERVATION AGREES
THAT LAB SAFETY SUPPLY, INC. IS ENTITLED TO ENFORCE THE TERMS OF THIS SHIPPING ORDER UNDER THE LAWS
OF THE STATE OF WISCONSIN AND IN A WISCONSIN FORUM.
VOUCHER 082707 WARRANT ALLOWED
%179310 IN SUM OF
LAB SAFETY SUPPLY
ACCT 6078343 r 1 p
PO BOX 5004 PER��
JANES VILLE, WI 53547 -5004
ti
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
1011996467 01- 6200 -06 $93.56
.a
Voucher Total $93.56
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
IN
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
179310
LAS SAFETY SUPPLY Purchase Order No.
ACCT 6078343 Terms
PO BOX 5004 Due Date 8/25/2008
JANESVILLE, WI 53547 -5004
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/25/2008 1011996467 $93.56
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