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179298 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 00350856 Page 1 of 1 ONE CIVIC SQUARE LEHIGH SAFETY SHOES CARMEL, INDIANA 46032 PO BOX 371958 CHECK AMOUNT: $1,669.87 PITTSBURG PA 15250 -7958 CHECK NUMBER: 179298 CHECK DATE: 11/11/2009 )EPARTMENT AC PO NUM BER I NU MBER AMOUNT DESCRIPTION 651 5023990 197490 69.99 OTHER EXPENSES x `651 5023990 434245 1,599.88 OTHER EXPENSES E H I H E rd 00 444 -4086 For Your to Access our Website Pa e 1 g OU FITTER .coy► highoutfitters.com Cust.No. Report Invoice Date Invoice# 39 East Canal Street Nelsonville, Ohio 45764 085893 00000 10917 197490 Sold To: Ship To: CARMEL WATER& WASTEWTR norman riley TREATMENT PLANT 9609 hazel dell pkwy 760 3RD AVE. SW CARMEL IN 46032 indianapolis,IN 46280 Customers Order Number SM Mobile -Unit Order Date Terms 83 027288 LH #5378 IND TRK 194 1 1 10/20/0 30 DAYS NET Line I Ticket Employee Id Employee Name Dept Other Amount Due Style WD Size Qty Price MDSE Amt Adjust Tax I Sery Chg Misc Total Sale Cash Recvd Subsidy Emp Bal DED 1 010917 NOMAN RILEY 5235 W 7.5 1 69.99 69.99 69.99 80.01 150.00 Total Qty Merchandise Value Adjustment Tax Sery Chg Misc Cash Rec Company Subsidy Amount Due 1 69.99 1 -80.01 69.99 Invoice nvoice LEHForm6M— 10/22/2009 7:35:01 AM- red0002) r Password to Access our Website HIGH11 www.lehighoutfitters.com OUTFITTERS= Cust.No. Report nvoice Date Invoice# 39 East Canal Street Nelsonville, Ohio 45764 085893 00000 00513 10/20/09 434245 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 Customers Order Number SM Mobile -Unit Order Date Terms 83 027288 LH #5378 IND TRK 194 10/20/09 30 DAYS NET I I Line Ticket Employee Id Employee Name Dept Other Amount Due Style WD Size Qty Price I MDSE Am. Adjust Tar Sery Chg Misc Total Sale I Cash Recvd Subsidy Emp Bal DED 1 010907 erast carter 61009 W 12 1 99.99 99.99 99.99 -50.01 2 010908 gary lafollette 86004 W 10 1 94.99 94.99 94.99 -55.01 3 010909 chris stubbs 1213 W II 1 80.00 80.00 80.00 -70.00 4 010910 dennis russ 5123 W 10 1 129.99 129.99 129.99 -20.01 5 010911 kevin buhmana 61009 W II 1 99.99 99.99 99.99 -50.01 6 010912 ralph gntwell 26063 W II 1 124.99 124.99 124.99 -25.01 7 010913 blaine mallaber 1213 M 10 1 80.00 80.00 80.00 -70.00 8 010914 robble kinkead 61009 M 11 1 99.99 99.99 99.99 -50.01 9 010915 eric robinson XSC561 W 8.5 1 60.00 60.00 60.00 -90.00 Continued... Call 1- 800 444 -4086 For Your IEHIG.H Password to Access our Website Page 2 OUTFITTERS www.lehighoutfitters.com Cust.No. Report Invoice Date Invoice# 39 East Canal Street Nelsonville, Ohio 45764 085893 00000 00513 434245 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 Customers Order Number SM Mobile -Unit Order Date Terms 83 027288 LH 45378 IND TRK 194 10/20/09 30 DAYS NET Line I Ticket Employee Id Employee Name Dept Other Amount Due Style WD I Size Qty Price I MDSE Annt Adjust Tax Sery Chg Misc Total Sale I Cash Recvd Subsidy Emp Bal UED 10 010916 lonnie patton R6003 M 12 1 94.99 94.99 94.99 -55.01 11 010918 bred oliver 5123 W 11 1 129.99 129.99 129.99 -20.01 12 010919 pete brennan 85007 W 9 1 134.99 134.99 134.99 -15.01 13 010920 jell cooper 5258 W 9.5 1 119.99 119.99 119.99 -30.01 14 010921 david turner 5123 W 10 1 129.99 129.99 129.99 129.99 15 010922 joe faucett 5258 M 10.5 1 119.99 119.99 119.99 119.99 Total Qty Merchandise Value Adjustment Tax Sery Chg Misc Cash Rec Company Subsidy Amount Due 15 1,599.88 1 1 1 1 1 -350.12 1,599.88 Orl gi na l Invoice (LEHFotm6M— 10/21 /2009 7:38:26 AM- red0002) 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 350856 LEHIGH SAFETY SHOES CO. Purchase Order No. P.O. Box 371958 Terms Pittsburgh, PA 15250 Due Date 11/2/2009 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 11/2/2009 434245 $1,599.88 (E 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 VOUCHIER #....096656 WARRANT ALLOWED 3,50856 IN SUM OF LEHIGHI SAFETY SHOES CO. P.O. Box 371958 Pittsburgh, PA 15250 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO IINV ACCT AMOUNT Audit Trail Code 434245 01- 7202 -05 $99.99 434245 01- 7202 -06 $1,499.89 �'1q�y4o d �262.o G F� 0 Voucher Total .88 Cost distribution ledger classification if claim paid under vehicle highway fund