226128 11/18/2013 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: $279.57
UTICA NY 13504 CHECK NUMBER: 226128
ON 0
CHECK DATE: 11/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1093 4239012 900651431 279 . 57 SAFETY SUPPLIES
AJORTHERN Remember... We Always Offer
- - 7 M Our Lowest Price When You Order. MM
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
northernsa fety.com
Utica, NY 13504-4250
SHIP TO(IF OTHER THAN"SOLD TO")
YOUR CUSTOMER ID
YOUR . OUR . AND Carmel Clay Parks&Recreation
ORDER NO.
4816021 Jim
1235 CENTRAL PARK DRIVE EAST
SOLD CARMEL IN 46032-4421
TO: Carmel Clay Parks&Recreation
USA
1411 E 116th St
CARMEL IN 46032-3455 RECE1 I Q1 E.fLJ
USA
NA'9`/ 0 4 2813 36351 10/30/2013
L JEW; YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED PAYMENT DUE BY 11/29/2013
INVOICE NO./ORDER NO.
900651431 !980210672 10/30/2013 FEDEX GROUND 10/30/2013 IF PAID BY 11/19/2013 PAY $ 274.39
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
1 1 27382 EA SCORPION LIMITER W/STEEL CARABINER 163.25 163.25
1 1 21863 XL EA NS PVC/NYLON/PVC 3PC RAINWEAR EXL 6CS 20.49 20.49
6 6 24179 L PR NS ALL WEATHER GLV L 10.34 62.04
1 1 2722 XL PR HVYWEIGHT TOP GRN PIGSKN MIG WELD GLV XL 13.17 13.17
•
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 $ 20.62 $ 279.57
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
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
10/30/13 900651431 Safety supplies 36351 $ 279.57
Total $ 279.57
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
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$
$ 279.57
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO#or Board Members
Dept#
INVOICE NO. ACCT#/TITLE AMOUNT
1093 900651431 4239012 $ 279.57 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
14-Nov 2013
Signature
$ 279.57 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund