208311 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 00351010 Page 1 of 1
ONE CIVIC SQUARE HALSEN PRODUCTS
CARMEL, INDIANA 46032 PO BOX 877 CHECK AMOUNT: $386.66
BELMONT MS 38827
CHECK NUMBER: 208311
CHECK DATE: 4/2512012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4356001 0114715 -IN 386.66 UNIFORMS
1
HALSEN PRODUCTS COMPANY INVOICE ®ICE PAGE
P.O. BOX 8TI
BE(_MONT, MS 38827
NATIONWIDE 1-800- 344 -6696 INVOICE N 0114 715 I N
FAX -1- NO-8"6 -8839 INVOICE DE DATE ATE: :4/5/2012
ORDER NUMBER:
ORDER DATE: 0523
SALESPERSON: 0230327
CUSTOMER NO:
SOLD TO SHIP TO
STREET DEPARTMENT
CITY OF CARMEL BONNIE CALLAHAN
ACCOUNTS PAYABLE DEPT 3400 WEST 131 STREET
3400 W 131ST ST Westfield, IN 46074
Westfield, IN 46074
CONFIRM TO:
CUSTOMER'P.O. $H!P VIA F.O:B TERMS
BONNIE
UPS Net 30
ITEM NO, UNIT ORDERED SHIPPED BACK ORDER PRICE AMOUNT 12
EACH 576
576 0 0.620
BJM92K
BROWN JERSEY GLOVE
Net Invoic 357'12
0.00
Freight, 29.54
THANK YOU FOR YOUR ORDER Sales.Ta 0.00
386.66
�Irivo c'e Tota�
0.00
Less Deposi
386.66
INVOICE BALANCE
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))
04/05/12 0114715 -IN $386.66
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 N
ALLOWED 20
Halsen Products
IN SUM OF
P. O. Box 877
Belmont, MS 38827
$386.66
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 0114715 -IN 43- 560.01 I $386.66 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
Thursday, Ap 19 2012
Street Commissioner
L`•tro�4 f^.nmmiccin:�or
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund