226765 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 226500 Page 1 of 1
\Lf ONE CIVIC SQUARE NORTHERN SAFETY CO,INC
CARMEL, INDIANA 46032 PO Box 4250
CHECK AMOUNT: $149.95
UTICA NY 13504 CHECK NUMBER: 226765
CHECK DATE: 12/3/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1093 4239012 900662039 149 . 95 SAFETY SUPPLIES
AJORTHERN 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 F_ Carmel Clay Parks&Recreation
• • • • Jim
• • • • • • • 1235 CENTRAL PARK DRIVE EAST
CARMEL IN 46032-4421
SOLD Carmel Clay Parks&Recreation USA
TO: 1411 E 1 16th St FN\
CARMEL IN 46032-3455
USA
v I ¢a 3
MC004774 11/07/2013
YOUR PURCHASE ORDER NUMBER AND DATE
OUR INVOICE DATE SHIPPED VIA DATE SHIPPED
_INVOICE NO./ORDER NO.
300662039 9802 4187 Ill 7720 13 IF PAID BY 11/27/2013 PAY $ 147.38
ORDERED SHIPPED ITEM NO. UOM DESCRIPTION UNIT PRICE EXTENDED AMOUNT
2 _9g 2 2 3551 BX NORTHERN PRE-MOISTENED LENS CLEANING TOW 8.00 16.00
2 2 21673 BX NS SOFT FIT CORDED FOAM PLUG 100PR/BX 21.99 43.98
1 1 23189 WE EA NS PWR SHELL W/RCHT SUSP WE 10.89 10.89
1 1 2186411 PR 17' OVER-THE-SHOE BTS SZ 11 20.95 20.95
1 1 2186413 PR 17' OVER-THE-SHOE BTS SZ 13 20.95 20.95
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1093- A239oi2.
SALES TAX SHIPPING&HANDLING •
ACCOUNTS 30 DAYS AND OVER ARE SUBJECT TO A FINANCE CHARGE OF 1'/,%PER
MONTH WHICH IS AN ANNUAL PERCENTAGE RATE OF 18%TO BE APPLIED TO THE
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
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
11/7/13 900662039 Safety equipment $ 149.95
Total $ 149.95
f 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$
$ 149.95
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1093 900662039 4239012 $ 149.95 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
27-Nov 2013
�-141dvaxo
Signature
$ 149.95 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund