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238897 11/05/14
(T,��i��4q�f( CITY OF CARMEL, INDIANA VENDOR: 357683 j �b ONE CIVIC SQUARE ON SITE SUPPLY CHECK AMOUNT: $*******126.48* * ?� CARMEL, INDIANA 46032 8782 ROBBINS ROAD CHECK NUMBER: 238897 9M�roN-�o•� INDIANAPOLIS IN 46268 CHECK DATE: 11/05/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 46285 126.48 OTHER EXPENSES v _ Invoice 8728 Robbins Road Date Invoice# indianapoLs,LN 46268 - 10/.5/2014 46285 Bill To Ship To City.of Carmel Water Utilities City of Cannel Water Utilities A/P Dept. Attn: Kerri 3450 West 131 St. 3450 West 131 St. Cannel, IN 46074 Carmel,IN 46074 P.O. Number Terms Rep Ship Via F.O.B. Net 30 MCC 10/13/2014 QTY Item Code Description Ul'i'A Price Each BIO Prev.-Invd Amount 2 Vv"IN 1420 Center-Flow Hand Towels,660 Sheets/RL,6RL/CS CS 44.74 0 - 0 89.48 1 BWK 385822BLK ,38X58 H-DENSITY BLK 22 C EQV 6/25 CS 37.00 i _0 . 0 _ - 37.00. - I Le i I i '_I I 'Subtdtal $126.48 I: - - =On-Site Supply is a certified Small Disadvantaged.Basiness(SDB),=and 8(a)cer*tied - _ I ane ' _. . - F�=' :. E-mail Sales Tai -(7.©°fa!_ _ __ =.$o:oo IToted- 0- 3 : $1,26.482�e7 971i mv.com 17-259-7788 or 88ar VOUCHER # 142162 WARRANT# ALLOWED 357683 IN SUM OF $ ON SITE SUPPLY 5546 SHOREWOOD DRIVE SUITE 101 INDIANAPOLIS, IN 46220 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR r Board members PO# INV# ACCT# AMOUNT Audit Trail Code I 46285 01-6200-06 $126.48 'y II Voucher Total $126.48 i 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 357683 ON SITE SUPPLY Purchase Order No. 5546 SHOREWOOD DRIVE Terms SUITE 101 Due Date 10/27/2014 INDIANAPOLIS, IN 46220 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount I 10/27/201, 46285 $126.48 I 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 Date Officer