225914 11/05/2013 - F CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
ONE CIVIC SQUARE NORTHERN SAFETY CO, INC CHECK AMOUNT: $1,117.24
CARMEL, INDIANA 46032 PO BOX 4250
UTICA NY 13504 CHECK NUMBER: 225914
CHECK DATE: 11/5/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1120 4356003 24487 900575625 515 . 64 GLOVES
1120 4356003 24487 900611077 257 . 82 GLOVES
1120 4356003 24487 900654043 343 . 78 GLOVES
NORTHERN Remember...We Always Offer
INVOU
MGM 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
nor-thernsafety.com Utica, NY 13504-4250
SHIP TO(IF OTHER THAN"SOLD TO")
YOUR CUSTOMER ID
• • . . . • . Carmel Fire Department
416610 2 Civic Sq
CARMEL IN 46032-2584
TOLD USA
Carmel Fire Department
2 Civic Sq
CARMEL IN 46032-2584
USA
Garry 09/03/2013
YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 10/03/2013
INVOICE NO./ORDER NO.
00575625/100327232 09/03/2013 FEDEX GROUND 09/03/2013 IF PAID BY 09/23/2013 PAY $ 505.33
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
24 24 1665 L PR 1921N LEA DRIVERS GLV KEYSTONE THUMB L 7.16 171.88
24 24 1665S PR GRAIN LEA DRIVERS GLV KEYSTONETHUMB SM 7.16 171.88
24 24 1665 M PR GRAIN LEA DRIVERS GLV KEYSTONE THUMB M 7.16 171.88
•
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 11/2%PER SALES TAX SHIPPING&HANDLING
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18%TO BE APPLIED TO THE
UNPAID BALANCE. $ 0.00 $ 0.00 $ 515.64
Payments must be sayable in US dollars only
ORTHERNRemember...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
. e . Carmel Fire Department
416610 2 Civic Sq
CARMEL IN 46032-2584
TOLD USA
Carmel Fire Department
2 Civic Sq
CARMEL IN 46032-2584
USA
Garry 09/03/2013
YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 10/30/2013
INVOICE NO./ORDER NO.
00611077/100327232 09/30/2013 FEDEX GROUND 09/30/2013 IF PAID BY 10/20/2013 PAY $ 252.66
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
36 36 1665 2XL PR GRAIN LEA DRIVERS GLV KEY/THUMB 2XL 7.16 257.82
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 $ 0.00 $ 257.82
_ Pavments must be oavable in US dollars only
PAGE 2 OF 2
j�VORTHEMRNIV Remember... We Always Offer
Our Lowest Price When You Order
.4 M== W 100%Satisfaction Guaranteed! Please Remit to:
PO Box 4250*Utica,NY 13504-4250 Northern Safety Co.,Inc.
Phone 800.631.1246*Fax 800.635.1591 P.O.Box 4250
North ernsafety.co m Utica,NY 13504-4250
........... SHIP Carmel Fire Department
.... YOUR CUSTOMER ID
........ ....... TO- 2 Civic Sq
........ 416610 CARMEL IN 46032-2584
XX
X:
. ...........
USA
BILL Carmel Fire Department
TO: 2 Civic Sq
CARMEL IN 46032-2584 Garry 09/03/2013
USA
YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 11/2912013
INVOICE NO/ORDER NO
900651043/100327232 10/30/2013 FEDEX GROUND 10/30/2013 IF PAID BY 11/19/2013 PAY$336.90
ORDERED SHIPPED ITEM NO LICIM DESCRIPTION UNIT PRICE EXTEND AMT
48 48 1665 XL PR GRAIN LEA DRIVERS GLV KEYSTONE THUMB XL 7.16 343.78
1 1 BC132 EA 2013 CATALOG KIT 0.00 0.0c
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE Sales Tax Shipping Total Due
CHARGE OF 1.5%PER MONTH WHICH IS AN ANNUAL PERCENTAGE
OF 18%TO BE APPLIED TO THE UNPAID BALANCE $ 0.0() $ 0.00 $ 343.78
Payments must be payable in US dollars only Thank You for Your Order!
**2%discount does not apply to credit card payments FEDERAL ID# 16-1214814
Please return bottom portion with payment:
VOUCHER NO. WARRANT NO.
ALLOWED 20
Northern Safety
IN SUM OF $
P.O. Box 4250
Utica, NY 13504
$1,117.24
ON ACCOUNT OF APPROPRIATION FOR
Carmel Fire Department
PO#D pt. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
24487 900575625 43-560.03 j $515.64 1 hereby certify that the attached invoice(s), or
24487 900611077 43-560.03 $257.82 bill(s) is (are) true and correct and that the
24487 I 900654043 I 43-560.03 I $343.78 materials or services itemized thereon for
which charge is made were ordered and
received except
F
Fire Chief
Title
Cost distribution ledger classification if
claim paid motor 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 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))
900575625 $515.64
900611077 $257.82
900654043 I I $343.78
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