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Home My WebLink About212713 09/12/2012 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: $262.27 UTICA NY 13504 CHECK NUMBER: 212713 ON� CHECK DATE: 9/12/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1081 4239012 900109435 119 . 99 SAFETY SUPPLIES 601 5023990 900116624 142 . 28 OTHER EXPENSES NORTHERN Remember...We Always Offer • Our Lowest Price When You Order. PLEASE REMIT To: PO Box 4250 • Utica, NY 13504-4250 100%Satisfaction Guaranteed! 7MNORTHERN 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 • • • • - • - • Carmel Water Distribution 3217619 Andy 5484 E 126TH ST SOLD CARMEL IN 46033-9289 TO: Carmel Water Distribution USA 3450 W 131st St CARMEL IN 46074-8267 USA andy 08/29/2012 YOUR PURCHASE ORDER NUMBER AND DATE OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 09/28/2012 INVOICE NO./ORDER NO. 900116624/100068282 08/29/2012 FEDEX GROUND 08/29/2012 IF PAID BY 09/18/2012 PAY $ 139.68 ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT 2 2 3122210 PR MEN STEEL TOE SNEAKER M WTH SZ 10 FR 64.95 129.90 1 1 SP2012CAT EA 2012 CATALOG KIT 0.00 0.00 SALES TAX SHIPPING&HANDLING ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 11/2%PER MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18%TO BE APPLIED TO THE UNPAID BALANCE. $ 0.00 $ 12.38 $ 142.28 Payments must be payable in US dollars only _ _ _ 6 _ _ _ _ "2%discount does not apply to credit card payments Th®nk You Tor Y®ur �ralE FEDERAL ID#16-1214814 VOUCHER # 122043 WARRANT # ALLOWED 226500 IN SUM OF $ NORTHERN SAFETY CO, INC PO BOX 4250 UTICA, NY 13504 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 900116624 01-6200-03 $142.28 t Voucher Total $142.28 Cost distribution ledger classification if claim paid under vehicle highway fund 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 226500 NORTHERN SAFETY CO, INC Purchase Order No. PO BOX 4250 Terms UTICA, NY 13504 Due Date 9/4/2012 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/4/2012 900116624 $142.28 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 ewcer KJORTHERN Remember... We Always Offer • Our Lowest Price When You Order. PLEASE REMIT TO: PO Box 4250 • Utica, NY 13504-4250 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 Carmel Clay Parks&Recreation 4816021 Nikesha 4311 E. 1 16th Street SOLD CARMEL IN 46033-3353 TO: Carmel Clay Parks&Recreation 1411 E 116TH ST USA CARMEL IN 46032 AU� 2 7 USA 2012 E0002795 08/23/2012 L BY:- YOUR PURCHASE ORDER NUMBER AND DATE OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 09/22/2012 INVOICE NO./ORDER NO. 900109435/980032566 08/23/2012 FEDEX GROUND 08/23/2012 IF PAID BY 09/12/2012 PAY $ 117.83 ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT 4 4 22078 L BX FLEXSHIELD PF PREM VINYL GLV 100BX L 6.09 24.36 2 2 24778 EA 1st AID SPRAY HYDROGEN PEROXIDE HP2-24 2.80 5.60 2 2 1759 EA BANDAGE SCISSOR SS STEEL 5.5' 3.29 6.58 3 2 7259 BX STERILE PADS 2"X 2'' 100BX 9.79 19.58 5 5 7804 RL 3M COBAN SLF ADHERENT WRAP 2"X5YD RL 2.97 14.85 5 5 6115 EA STRETCH GAUZE BANDAGE 2'X 2 YD 2.01 10.05 2 2 31962 BX NS TRIPLE ANTIBOITIC CREAM 20/BX 3.60 7.20 4 4 31963 EA NS TRIANGULAR BANDAGE 1.80 7.20 5 5 Pu cha 799 EA IRRIGATE EYE WASH 1 OZ 19828 2.50 12.50 Ds 0 cription P _P r F G. .# �r7 BU. t Li Descr Q[5'OM PU chaser nDa te ACCOUNTS 30 DAYS Qf� I FR%E-6t=-9'ffiir PER SALES TAX SHIPPING&HANDLING • • MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18%TO BE APPLIED TO THE UNPAID BALANCE. $ 0.00 $ 12.07 $ 119.99 Payments must be payable in US dollars only "2%discount does not apply to credit card payments Thank You for Your ®r_d6d 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 8/23/12 900109435 Safety supplies $ 119.99 Total $ 119.99 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$ $ 119.99 ON ACCOUNT OF APPROPRIATION FOR 108 - ESE PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members Dept# 1081-11 900109435 4239012 $ 119.99 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 6-Sep 2012 Signature $ 119.99 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund