206373 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
ONE CIVIC SQUARE NORTHERN SAFETY CO, INC CHECK AMOUNT: $207.26
z` CARMEL, INDIANA 46032 PO Box 4250
«o `a UTICA NY 13504 CHECK NUMBER: 206373
CHECK DATE: 2/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4239012 I07415120101 207.26 SAFETY SUPPLIES
NO RTHERN Remember... We Always Offer
Our Lowest Price When You Order. INC.
PLEASE REMIT T o:
PO Box 4250 Utica, NY 13504 -4250 100% Satisfaction D uaranteed� �f� NORTHERN SAFETY CO.,
Phone: 800. 631 1246 Fax: 800. 635. 1591 a 9
P.O. Box 4250
northernsafety. com
F B 2 01 2 Utica, NY 13504 4250
tIDt SHIP TO (IF OTHER THAN "SOLD TO
'PL EASE REFER i 'TO YOUR CUSTOMER ID OUR INV DICE AND
YOUR CUSTOMER ID I ERIC MEHL
0004816021 CARMEL CLAY PARKS RECREATION
1235 CENTRAL PARK DRIVE EAST
SOLD CARMEL, IN 46033
TO: CARMEL CLAY PARKS RECREATION
1411 E 116TH ST
CARMEL, IN 46032 L_
MC002534 01127112
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 02126112
INVOICE NOJORDER NO.
I074151201015 01127112 FEDEX GROUND 01/27/12
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
10 10 249 -5634 01 BX BAND -AID PLSTC STRIPS 3/4" X 3" 100BX J &J 4.76 47.60
3 3 250 -1728 01 EA HYDROGEN PEROXIDE 16 OZ BOT 1.39 4.17
3 3 109 -4115 01 EA EYESALINE PERSONAL EYE WASH 4 OZ BOTTTLE 452 3.99 11.97
10 1 122 -24172 M 01 BX NS INDUST POWD NITRILE GLV M 5.99 59.90
10 1 122 -24172 L 01 BX NS INDUST POWD NITRILE GLV L 5.99 59.90
1 1 SP2012CAT 01 EA 2012 CATALOG .00
Purchase
Cescription Fi f 5+ N\ C\
P.O. f oo P CIO
G.L.
Line D
Line escr c
Purchaser Date
Approval Date
SALES TAX SHIPPING HANDLING
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1'h PER
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE 23
UNPAID BALANCE.
Payments- must -be payable in US- dollars only
2% discount does not apply to credit card payments Thank You for Your Order!
FEDERAL ID# 16- 1214814
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.
226500 Northern Safety Co., Inc. Terms
P.O. Box 4250
Utica, NY 13504 -4250
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
1/27/12 1074151201015 First aid supplies 207.26
Total 207.26
1 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.
226500 Northern Safety Co., Inc. Allowed 20
P.O. Box 4250
Utica, NY 13504 -4250
In Sum of
207.26
ON ACCOUNT OF APPROPRIATION FOR
101 -General fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1094 1074151201015 4239012 207.26 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
9 -Feb 2012
l� &h ii 11Y
Signature
207.26 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund