220278 05/21/2013 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: $272.57
UTICA NY 13504 CHECK NUMBER: 220278
CHECK DATE: 5/21/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1081 4239039 900397238 234 . 72 GENERAL PROGRAM SUPPL
1095 4239039 900401098 37 . 85 GENERAL PROGRAM SUPPL
n0CTLI�I LS�ll`.l .Remember... We Always Offer
u v Our Lowest Price When You Order. PLEASE REMIT TO:
PO Box,4250 • Utica, NY 13504-4.250 100%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
PLEASE •YOUR CUSTOMEWID,OUR • • Carmel Clay Parks&Recreation
R • . •
4816021 Kurtis
1235 CENTRAL PARK DRIVE EAST
OLD F ��t � USAMEL IN 46032-4421
TO: Carmel Clay Parks &Recreation �� T
1411 E 1 16TH ST L
CARMEL IN 46032 APR 3 0 2013
USA v
MC004049 04/25/2013
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED Dl)_E_BY 0.5L25/201.3�_
INVOICE NO.;OF,R NO.
00401098/980130927 04/25/2013 FEDEX GROUND 04/25/2013 IF PAID BY 05/15/2013 PAY $ 37.25
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
5 5 24671 BX MET DETECTABLE BANDAGES WOVEN 100BX 5.98 29.90
Purchase
C lescription pA 1 DS —►=lDSEJ2�/lC6s
P.O.# rAC 004049 P or
G.L.# LC 16-1 —J-4Z'!7qa
Budget
Lins Descr
Purchaser Date
Approval Date
I
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 $ 7.95 $ 37.85
g(00 THERCI LI�l 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 &Rec
4816021 James
12415 SHELBORNE ROAD
SOLD CARMEL IN 46032
TO: Carmel Clay Parks&Recreation USA
1411 E 116TH ST
CARMEL IN 46032 APR 3 0 2013 L
USA
B'Y',I E0003283 04/23/2013
L YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 05/23/2013
INVOICE NO./ORDER NO.
00397238/980129433 04/23/2013 FEDEX GROUND 04/23/2013 IF PAID BY 05/13/2013 PAY $ 230.44
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
2 2 1 105 CS PLSTC STRIPS 3/4x3" BULK PK 1500/CS 46.43 92.86
6 6 24776 EA 1 st AID SPAAY BURN SPRAY BS2-24 3.16 18.96
6 6 24778 EA 1 st AID SPRAY HYDROGEN PEROXIDE HP2-24 2.84 17.04
15 15 2110 EA CPROTECOR 2000 POLY BG 4.44 66.60
1 1 4646 BX HYDROCORTISONE CREAM 1% 144/BX 18.75 18.75
Purchase
Description
P.O.#. 6F 10100 P op
G.L. IDSl�-3- 4J23RU39
Budget
Line Descr_ -7-� '/
Purchaser V �GLI Date
Approval Date
SALES TAX SNIPPING&HANDLING
ACCOUNTS 30 DAYS ANDOVER ARE SUBJECT TO A FINANCE CHARGE OF 11b%PER ," •'
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18%TO BE APPLIED TO THE
UNPAID BALANCE. S 0.00 S 20.51 $ 234.72
Pavments must be savable in US dollars only
1
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
$ 37.85
4/25/13 900401098 Band aids for Food Services $ 234.72
4/23/13 900397238 Supplies
Total $ 272.57
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
, 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$
$ 272.57
ON ACCOUNT OF APPROPRIATION FOR
108 - ESE/ 109 Monon Center
PO#or Board Members
INVOICE NO. ACCT#/TITLE AMOUNT
Dept#
1095-1 900401098 4239039 $ 37.85 1 hereby certify that the attached invoice(s), or
1081-3 900397238 4239039 $ 234.72 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
16-May 2013
Signature
$ 272.57 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund