240285 12/16/14 Jy'�,q?'` CITY OF CARMEL, INDIANA VENDOR: 092000
® ONE CIVIC SQUARE FASTENAL CHECK AMOUNT: $*******314.62*
:� ;=a CARMEL, INDIANA 46032 PO BOX 978 CHECK NUMBER: 240285
9�'��roN�O, WINONA MN 55987-0978 CHECK DATE: 12/16/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 ININ816302 314.62 OTHER EXPENSES
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I ® Remit to INVOICE
Fastenal Company Page 1 of 1
P.O. Box 978
Winona, MN 55987-0978 Invoice Date Invoice No.
11/24/2014 ININ816302
Cust No. ININ80387 For billing questions Invoice Total
Cust.P.O. 1010 Kendall Court, Suite 3
Job No. WESTFIELD, IN 46074 336.64 USD
Contract No. Phone 317-804-8035 Due Date
Fax 317-804-8037 12/15/2014
Sold To
Ship To
CARMEL WASTEWATER TREATMENT CARMEL WASTEWATER TREATMENT
9609 HAZEL DELL PKWY 9609 HAZEL DELL PKWY
INDIANAPOLIS, IN 46280-2935 INDIANAPOLIS, IN 46280-2935
This Order and Document is subject to the "Terms of Purchase" posted on www.fastonal.com.
Line Quantity Quantity Quantity Control Part Price/
No Ordered Shipped Backordered Description No. No. Hundred Amount
1 30 30 0 S/S HCS 5/8-11 X 3 190071151 70315 336.0000 100.80 T
2 10 10 0 S/S HCS 3/4-10X3 1/2 180087722 70367 579.2000 57.92 T
3 10 10 0 1/2-13X1 1/4S/S HCS 120181345 1170207 102.4000 10.24 T
4 10 10 0 1/2-13 X 2 HCS S/S 120186871 1170211 146.4000 14.64 T
5 2 2 0 S/S CB 1/2-13 X 3 220015643 74452 280.8000 5.62 T
6 10 10 0 5/8"-11 S/S FHN 120137355 1170716 86.7000 8.67 T
7 20 20 0 5/8"-11 S/S FHN 120196941 1170716 86.7000 17.34 T
8 25 25 0 1/2"-13 S/S FHN 120178767 1170714 43.0400 10.76 T
9 10 10 0 3/4"-10 S/S FHN 120106057 1170717 160.0000 16.00 T
10 2 2 0 1/2 X 4"S/S Nipple 134515 0464368 606.1000 12.12 T
11 4 4 0 3/4 X 4"S/S Nipple 134515 0464369 735.3000 29.41 T
Received By Tax Exemption Subtotal 283.52 f'
Shipping&Handling' A 1 1 nFQ�°Q
Comments IN State Tax 22.0
County Tax 0.00
Contact:Duane Jarvis City Tax 0.00
Total W4
Reasonable collection and attorneys fees will be No materials accepted for return without our permission.
assessed to all accounts placed for collection. All discrepancies must be reported within 10 days.
If you re-package or re-sell this product, you are required to maintain Please pay from this invoice.
integrity of Country of Origin to the consumer of this product.
0024196-03-0074701 Invoice: ININ816302 Cust: ININ80387
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VOUCHER # 146221 WARRANT # ALLOWED
92000
IN SUM OF $
FASTENAL COMPANY
PO BOX 978
WINONA, MN 55987-0978
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Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
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.; Board members
PO# INV# ACCT# AMOUNT I Audit Trail Code
ININ816302 01-7202-06 $314.62
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Voucher Total $314.62
Cost distribution ledger classification if
claim paid under vehicle highway fund
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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
92000
FASTENAL COMPANY Purchase Order No.
PO BOX 978 Terms
WINONA, MN 55987-0978 Due Date 12/10/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/10/201, ININ816302 $314.62
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
Date Officer