170038 03/18/2009 a CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
ONE CIVIC SQUARE NORTHERN SAFETY CO, INC
CARMEL, INDIANA 46032 PO BOX 4250
CHECK AMOUNT: $817.63
UTICA NY 13504 CHECK NUMBER: 170038
CHECK DATE: 3/1812009
DEPARTMENT ACCOUN PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 P23649280000 248.57 MATERIALS SUPPLIES
1120 4356001 P236508 569.06 UNIFORMS
I
ti
Remember... We Always Offer
Our Lowest Price When You Order.
PLEASE REMIT TO:
PO Box 4250. Utica, NY 1 3504 4250 100% Satisfaction Guaranteed! NORTHERN SAFETY CO., INC.
Phone: 800.631. 1246`. Fax: 800. 635. 1591 P.O. Box 4250
northernsafety.com Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID
PLEASE REFER TO YOUR YOUR CUSTOMER
0000416610
TOL CARMEL FIRE DEPARTMENT
2 CIVIC SQUARE
CARMEL, IN 46032
GARY CARTER 03/04/09
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 04/03/09
INVOICE NO. /ORDER NO.
P236508600016 03/04/09 UPS GROUND 03/04/09 IF PAID BY 03/24/09 PAY $557.99
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
60 60 123 -1665 L 01 PR GRAIN LEA DRIVERS GLV KEYSTONE THUMB LG BROWN 6.59 395.40
24 24 123 -1665 XL 01 PR GRAIN LEA DRIVERS GLV KEYSTONE THUMB XL BLUE 6.59 158.16
1 1 93- 28553F 01 EA EXECUTIVE PORTFOLIO .00
1 1 SP2009CAT 01 EA 2009 CATALOG BC082 .00
SALES TAX SHIPPING HANDLING
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1 1 /2 PER
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE
UNPAID BALANCE. 15.50 569.06
Payments must be payable in US dollars only
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
P236508 Gloves $569.06
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.
ALLOWED 20
JNorthern Safety
IN SUM OF
P.O. Box 4250
Utica, NY- 13504
$569.06
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT Board Members
1120 P236508 43- 560.01 $569.06 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
MAR 16 2009
V
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
11 RTHERN Remember... We Always Offer
Our Lowest Price When You Order.
PLEASE REMIT TO:
PO Box 4250. Utica, NY 1'3504 -4250 100% Satisfaction Guaranteed! NORTHERN SAFETY CO., INC.
Phone: 800. 631 12466. Fax: 800. 635. 1591 P.O. Box 4250
northernsafet Utica, NY 13504 -4250
SHIP TO (IF OTHER THAN "SOLD TO
YOUR CUSTOMER ID
0002411866
TOL CITY OF CARMEL
ATTN UTILITIES DEPT
3450 W 131ST ST L
WESTFIELD, IN 46074
DAN 03/04/09
L 40 YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 04/03/09
INVOICE NO. /ORDER NO.
P23649280-0028 03/04/09 UPS GROUND 03/04/09 IF PAID BY 03/24/09 PAY $243 82
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
4 4 153 -2727 01 BX SURVIVAIR ACID GAS /P100 CARTRIDGE 4 /BX 105210 39.57 158.28
2 2 153 -2727 02 BX SURVIVAIR ACID GAS /P100 CARTRIDGE 4 /BX 105210 39.57 79.14
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 142% PER SALES TAX SHIPPING HANDLING
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% TO BE APPLIED TO THE
UNPAID BALANCE. 11.15 248.57
Payments must be payable in US dollars only
2% discount does not apply to credit card payments Thank You for Your Order!
=r)CDA1 ina 1CZ- 101AQ1n
Prescribed by State Board of Accounts City Form No. 201 (Rev 199`)
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
226500
NORTHERN SAFETY CO, INC Purchase Order No.
PO BOX 4250 Terms
UTICA, NY 13504 Due Date 3/12/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/12/2009 P2364928001 $248.57
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
VOUCHER 091305 WARRANT ALLOWED
23500 IN SUM OF
NORTHERN SAFETY CO, INC
PO BOX 4250�
UTICA, NY 13504
PAI
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
P2364928000 01- 6200 -04 $248.57
I Voucher Total $248.57
Cost distribution ledger classification if
claim paid under vehicle highway fund