240990 01/13/15 �,q,f CITY OF CARMEL, INDIANA VENDOR: 092000
;; ® _ ONE CIVIC SQUARE FASTENAL COMPANY CHECK AMOUNT: S"`"'"239.88'
x. CARMEL, INDIANA 46032 PO BOX 1286 CHECK NUMBER: 240990
.M`uri`o, WINONA MN 55987-1286 CHECK DATE: 01/13/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4238900 ININ816656 239.88 OTHER MAINT SUPPLIES
® Remit to INVOICE
FAS7EWFastenal Company Page 1 of 1
P.O. Box 1286
Winona, MN 55987-1286 Invoice Date Invoice No.
01/07/2015 ININ816656
Cust.No. ININ80003 For billing questions
Cust.P.O. 1010 Kendall Court,Suite 3 Invoice Total
Job No. WESTFIELD, IN 46074 239.88 USD
Contract No. Phone 317-804-8035 Due Date
Fax 317-804-8037 02/06/2015
Sold To
Ship To,
CARMEL STREET DEPT. CARMEL STREET DEPT.
3400 W 131ST ST 3400 W 131ST ST
WESTFIELD, IN 46074-8267 WESTFIELD, IN 46074
This Order and Document is subject to the"Terms of Purchase"posted on www.fastenal.com.
Line Quantity Quantity Quantity Control Part Price/
No Ordered Shipped Backordered Description No. No. Hundred Amount
1 12 12 0 WetHandTowe172CtPail GEORPF 0613000 1,999.0000 239.88
Received By Tax Exemption Subtotal 239.88
0031201550-020 G Shipping&Handling 0.00
Comments IN State Tax 0.00
County Tax 0.00
Contact:Eric Russell City Tax 0.00
Total 239.88
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.
Invoice: ININ816656 Cust: ININ80003
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))
01/07/15 I N I N816656 $239.88
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
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fastenal
IN SUM OF $
P. O. Box 1286
Winona, MN 55987-0978
$239.88
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 ININ816656 42-389.00 $239.88 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
ritiy ativa , 2'015
r���a� �E.m.r��ccinnar
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund