161447 07/11/2008 CITY OF CARMEL, INDIANA VENDOR: 179310 Page 1 of 1
ONE CIVIC SQUARE LAB SAFETY SUPPLY INC CHECK AMOUNT: $123.00
CARMEL, INDIANA 46032 Po Box 5004
JANESVILLE WI 53547 -5004 CHECK NUMBER: 161447
CHECK DATE: 7/11/2008
DEPARTMENT ACCOUNT PO NUMBER INV N UMBER AMOUNT DESCRIPTION
y 651 5023990 1011736876 123.00 OTHER EXPENSES
�f.
Order By Phone: 1- 800- 356 -0783 Lab Safety Supply Inc.
Order Online: wtivw.LSS.com FEI 39- 1726218
SM Order By Fax: 1- 800 -543 -9910 GST# 894097476RT
401 S. Wright Rd. PO Box 1368
Technical Support: 1 -800 -356 -2501 Janesville WI U.S.A 53547-1368
LAB SAFETY SUPPLY
PO Box 1368
Janesville, WI USA 53547 -1368
e
003872 PAGE 1 OF 1
8> CITY OF CARMEL CITY OF CARMEL
ACCOUNTS PAYABLE _,12 901 N RANGE LINE RD
760 3RD AVE SW'' HOUSEHOLD HAZ WASTE
t CARMEL IN 46032 -2072 [:z CARMEL IN 46032 -1361
t7
0rde Rao P i7 hfo S ®]d:: Try Nra InvoECe RIr� Invetc� Gate Due
SCO3366208 ARNONE06232008 5208 1 1011736876 06/23/2008 07/23/2008
BuyeC Carver :l^retgh.. r$r?.> Ship #date: ...paYmetifi 7rrn
ARNONE,PAUL UPSGND LOCKED 06/23/2008 Net 30
ANE RRQfJUC T Nf i�E C91 T-10
1�1 t� SHIP U Q M A 11 14 AI�l1 1J VT
1 121947L GLV EXAM SYNETRON PWDRF LATE 0 10.00 BX 11.30 113.00
SUBTOTAL: 113.00
Thank you for your order. FREIGHT: 10.00
TAXES: 0.00
PAYMENT TERMS: Net 30 TOTAL AMOUNT DUE BY 07/23/2008 123.4SD
ORI
After 90 days from invoice date, Lab Safety Supply, Inc. will 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. r
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 085832 WARRANT ALLOWED
179310 IN SUM OF
LAB SAFETY SUPPLY INC.
Acct 5208827
'P.O. Box 5004
4anesville W 53547
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
1011736876 01- 7200 -02 $123.00
Voucher Total $123.00
,.Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
T
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. tf�
Payee
179310
LAB SAFETY SUPPLY INC. Purchase Order No.
Acct 5208827 Terms
P.O. Box 5004 Due Date 6/30/2008
Janesville, WI 53547
Invoice Invoice Description
Date Number (or note attached invoices) or bill(s)) Amount
6/30/2008 1011736876 $123.00
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