157145 03/05/2008 CITY OF CARMEL, INDIANA VENDOR: 00350856 Page 1 of 1
0 ONE CIVIC SQUARE LEHIGH SAFETY SHOES CHECK AMOUNT: $109.99
CARMEL, INDIANA 46032 PO BOX 371958
PITTSBURG PA 15250 -7958 CHECK NUMBER: 157145
CHECK DATE: 3/5/2008
DEPARTMENT AC COUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 264611 219.98 OTHER EXPENSES
651 5023990 721243 109.99 OTHER EXPENSES
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NvK 39 East Canal Street Cust.No. Repots Invoice Date Invoice#
N.Isonville, Ohio 45764 085893 00000 00205 1 02/25/08 264611
Sold To: Ship To:
CARMEL WATER& WASTEWTR CARMEL WATER& WASTEWTR
TREATMENT PLANT TREATMENT PLANT
760 3RD AVE. SW 9609 HAZEL DELL PKWY
CARMEL IN 46032 INDIANAPOLIS, IN 46280
Customer's Order Number SNI Mobile -Unit Order Date Terms
85 447660 LEHIGH #5378- INDIANAPOLIS 02/25/08 30 DAYS NET
Line "ticket Employee Id Employee Name Dept her Amount Due
Style WD I Size Qty Price I MDSE Amt Adjust Tax Set, Chg Misc "t'ntat Sale I Cash Recr d Subsidy Emp Bat DED
1 005161 Lary Edison
5258 W I4 1 109.99 109.99 109.99 109.99
2 005165 Lary Edison
5258 W 14 1 109.99 109.99 109.99 109.99
Total Qty Merchandise Value Adjustment Tax Sery Chg Misc Cash Rec Subsidy Amount Due
2 219.98 219.981 219.98
The Goods covered by this Invoice were produced in compliance with the Fair Labor Standards Act of 1938, as amended.
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39 East Canal Street CREDIT MEMORANDUM Cust.No. Report Credit Date Credit#
Nelsonville, Ohio 45764 085893 00000 00205 02/25/08 721243
Sold To: Ship To:
CARMEL WATER& WASTEWTR CARMEL WATER& WASTEWTR
TREATMENT PLANT TREATMENT PLAINT
760 3RD AVE. SW 9609 HAZEL DELL PKWY
CARMEL IN 46032 INDIANAPOLIS, IN 46280
Customer's Order Number Sisntn Mobile Unit Order Date Terms
85 447660 LEHIGH #5378 INDIANAPOLIS 02/25/08 lCredit
Line Ticket Employee Id Employee Nmne Dept Other Credit Amount wD Size Qty Price MDSE Amt Adjust Tae Sere Chg Nlisc Total Sale Cash Recvd Subsidy Emp E3al UED
I 005164 Larry Edison
5258 w 14 -1 109.99 109.99 109.99 109.99
Total Qty Merchandise Value Adjustment Tax Sery Chg Misc Cash Rec Subsidy Amount Due
I --=109:99 109 -99 109.99
The Goods covered by this Invoice were produced in compliance with the Fair Labor Standards Act of' 1938, as amended.
O riginal Credit Memo Lr_HForn7N1 2n60008 6:36:30 AN1- rvb0002)
V OUCHER 077449 WARRANT ALLOWED
350856 IN SUM OF
LEHIGH SAFETY SHOES CO..
P.O. Box 371958
Pittsburgh, PA 15250
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
264611 01- 7200 -01 $109.99
7. 1.2.y.3- Cl aa.ya)
Voucher Total $109.99
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
r 350856
LEHIGH SAFETY SHOES CO. Purchase Order No.
P.O. Box 371958 Terms
Pittsburgh, PA 15250 Due Date 2/29/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/29/2008 264611 $109.99
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