218964 04/09/2013 CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
`` • ONE CIVIC SQUARE NORTHERN SAFETY CO, INC
F CARMEL, INDIANA 46032 Po Box 4250
CHECK AMOUNT: $355.47
UTICA NY 13504
CHECK NUMBER: 218964
CHECK DATE: 4/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 900344468 130 . 55 OTHER EXPENSES
1091 4239012 900353661 224 . 92 SAFETY SUPPLIES
NORTHERN 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
• 9, • • � • • � Carmel Clay Parks&Recreation
4816021 Kurtis
1235 CENTRAL PARK DRIVE EAST
SOLD CARMEL IN 46032-4421
TO: Carmel Clay Parks&Recreation _
1411 E 116TH ST [TFFZ `CE1V E D L USA
CARMEL IN 46032
USA MAR 2 5 2013
MC003930 03/20/2013
L BY: YOUR PURCHASE ORDER NUMBER AND DATE
OUR
DER NO. INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT—DUE BY 04/19/2013_
INVOICE NO./OR
00353661 /980115100 03/20/2013 FEDEX GROUND 03/20/2013 IF PAID BY 04/09/2013 PAY $ 220.81
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
50 50 31039 BX BAND AID SHEER STRIPS ASSORTED PK/80 4.11 205.50
Purc,asa r 19,57 NI T> 5U P PUPS
P�.6-0 "A C O_O_3r--t 3D or,
ii,ia�[D�tEt''
e
te
SALES TAX SHIPPING&HANDLING •
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1112%PER
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18%TO BE APPLIED TO THE
UNPAID BALANCE $ - 0.00- - -- -- ---$ 19.42 -5-= 224.92 -
Payments must be payable in US dollars only
1 k
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.,1nc. Terms
P.O. Box 4250
Utica, NY 13504-4250
Invoice Invoice _ Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
3/20/13 900353661 First aid supplies $ 224.92
Total $ 224.92
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
120
Clerk-Treasurer
Voucher No. Warrant No.
226500 Northern Safety Co., Inc. Allowed 20
P.O. Box 4250
Utica, NY 13504-4250
In Sum of$
$ 224.92
ON ACCOUNT OF APPROPRIATION FOR
IMMOM
(09 MONOn1 C&JMM -
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1091 900353661 4239012 $ 224.92 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
4-Apr 2013
Signature
$ 224.92 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
®R�H�R� Remember... We Always Offer
INVOICE
�Nj - - • 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 Utilities
346023 Jerry
4915 E 106th St
SOLD CARMEL IN 46033
TO: Carmel Utilities
USA
3450 W 131 st St
CARMEL IN 46074-8267
USA
dan031313a 03/13/2013
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 04/12/2013
INVOICE NOJORDER NO.
00344468/100199490 03/13/2013 FEDEX GROUND 03/13/2013 IF PAID BY 04/02/2013 PAY $ 128.26
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
1 1 1760210 PR DR MARTENS WELLINGTONS STEEL TOE SZ 10 114.38 114.38
1 1 BC132 EA 2013 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 $ 0.00 $ 16.17 $ 130.55
UNPAID BALANCE. - -
Payments-must-be-payable-in-US-dollars only -------- —
"2%discount does not apply to credit card payments Thank You for Your Order!
FEDERAL ID#16-1214814
VOUCHER # 131251 WARRANT # ALLOWED
226500 j IN SUM OF $
NORTHERN SAFETY CO, INC '
f
PO BOX 4250
UTICA, NY 13504
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
900344468 01-6200-03 $130.55
1
I
Voucher Total $130.55
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 4/1/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/1/2013 900344468 $130.55
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
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Date Officer