177114 09/15/2009 ^A CITY OF CARMEL, INDIANA VENDOR: 354024 Page 1 of 1
ONE CIVIC SQUARE BEN MEADOWS COMPANY
CARMEL, INDIANA 46032 ACCT 62601 B2 CHECK AMOUNT: $178.67
PO BOX 5275
�roh�o CHECK NUMBER: 177114
JANESVILLE 1M 53547 -5275
CHECK DATE: 9/15/2009
DEPART ACCOUNT PO NU I NVOICE NUM AMOUNT DESCRIPTION
1125 4356004 1013992758 178.67 STAFF CLOTHING
4.-
Division of Lab Safety Supply, Inc.
sm 401 S Wright Rd PO Box 5275 When
the C� Janesville WT USA 53547 -5275 �i d�d EN 19 'ux 1ow U Phone: 800 -241 -6401 Fax: 800- 628 -2068 Your
Online: www.benmeadows.com
P.O. Box 5275
Janesville, o 53547 -5275 FEW 39- 1726218 GST# 894097476RT Office
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000477 PAGE 1 OF 1
�B< CARMEL CLAY PARKS RECREATION S CARMEL CLAY PARRS RECREATION
Li y.
ACCOUNTS PAYABLE 1; 1427 E 116TH ST
1411 E 116TH ST L1000 L z gnJ CARMEL IN 46032 -3455
CARMEL IN 46032 -345-9 T
i.
Clydet o t? No Sall Ta No, Ih' it tin Irtivt�Ece. f}$i� Ruo. fiats
rSCO 416191 22481 6260182 2 1013992758 08./2,1/2009 09/20/2009
yar arr�er re�Ok�t..�er a :i 3at$ P snt TKy
GARSKE,SERRA UPSGND LOCKED 08/21/2009 Net 30
4TY 0 y UNiT
111IE PRQ.f LI�T..NC S R Tlpl C3 H P EJ 1111 U J#M 3t 3 €T
1 152501 -11 HIP WADER PROLINER 3 PLY 0 1 PR 59.90 59.90
2 152519 -11 CHST WDRS TWIN RIVER GRN 420 0 2 PR 49.95 99.90
Purchase
Description PLC
P.O. a g L4 0 1 P oO no
G.L. H I L 25 4�
Bud�t t CI�I hu�a
Line esc
Purchaser. Date
Approval Cate
SUBTOTAL: 159.80
Thank you for your order. FREIGHT: 18.87
TAXES: 0.00
TERMS: Net 30 TOTAL AMOUNT DUE BY 09/20/2009 (`178:67 BSA
ORIGINAL,
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.
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.
Wff
a
r
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
Payee Purchase Order No.
Ben Meadows Terms
P.O. Box 5275
Janesville, WI 53547-5275
j voice Invoice Description ate Number (or note attached invoice(s) or bill(s)) PO Amount
21109 1013992758 Hi waders for maintenance dept.
22481 F 178.67
Total 178.67
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
20_
Clerk- Treasurer
Voucher No. Warrant No.
Ben Meadows Allowed 20
P.O. Box 5275
Janesville, WI 53547 -5275
In Sum of
178.67
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund
PO# or INVOICE NO. ACCT #fTITLE AMOUNT Board Members
Dept
1125 1013992758 4356004 178.67 1 hereby certify that the attached invoice(s), or
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
10 -Sep 2009
Signature
178.67 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund