HomeMy WebLinkAbout176326 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 00350856 Page 1 of 1
ONE CIVIC SQUARE LEHIGH SAFETY SHOES CHECK AMOUNT: $129.99
s` CARMEL, INDIANA 46032 PO BOX 371958
PITTSBURG PA 15250 -7958 CHECK NUMBER: 176326
CHECK DATE: 8/19/2009
DEPARTMENT ACC OUNT P O NUMBER IN N AMOUNT DESCRIPTION
x'.651 5023990 415579 129.99 OTHER EXPENSES
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Rocky Brands Retail LLC Cust.No. Repoli Invoice Date Invoice#
39 East Canal Street
Nelsonville, Ohio 45764 085893 00000 00486 415579
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
new hire 85 027288 LH #5379 IND TRK 194 07/29/09 30 DAYS NET
Line Ticket Employee Id Employee Name Dept Other Amount Due
Style WD Size Qty Price I MDSE Amt Adjust Tax Sery Chg Mise Total Sale I Cash Recvd Subsidy Emp 13 1 DED
1 010475 David Turner
88005 M 10 1 129.99 129.99 129.99 129.99
Total Qty Merchandise Value Adjustment Tax Sery Chg Misc Cash Rec Company Subsidy Amount Due
1 129.99 129.99 129.99
The Goods covered by this Invoice were produced in compliance with the Fair Labor Standards Act of 1938, as amended.
Original Invoice (LEHForm6M— 7/30/2009 7:34:28 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 8/11/2009
Q
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/11/2009 415579 $129.99
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
VOUCHER 096206 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
415579 01- 7202 -05 $129.99
I�9
Voucher Total $129.99
Cost distribution ledger classification if
claim paid under vehicle highway fund