243491 03/24/15 v4A,,'. CITY OF CARMEL, INDIANA VENDOR: 092000
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ONE CIVIC SQUARE FASTENAL COMPANY CHECK AMOUNT: 8.'•"•""74.36'
s ,?� CARMEL, INDIANA 46032 PO BOX 1286 CHECK NUMBER: 243491
�r„��oN WINONA MN 55987-1286 CHECK DATE: 03/24/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350080 ININ807330 74.36 STREET LIGHT REPAIRS
FASMMO
Remit to INVOICE
Fastenal Company Page 1 of 1
P.O. Box 1286
Winona, MN 55987-1286 Invoice Date Invoice No.
03/18/2015 I N I N 817330
Cust.No. ININ80003 For billing questions
Cust.P.O. Truck 57 1010 Kendall Court,Suite 3 Invoice Total
Job No. WESTFIELD, IN 46074 74.36 USD
Contract No. Phone 317-804-8035 Due Date
Sold To Fax 317-804-8037 04/17/2015
Ship To
CARMEL STREET DEPT. Picked up at branch
3400 W 131 ST ST 1010 Kendall Court,Suite 3
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
1 100 100 0 HCS5/16-18 X 3 Z 5 120190294 110120333 54.5000 54.50
2 100 100 0 5/16 X 1 FEND Z 220015263 1133213. 12.9600 12.96
3 100 100 0 5/16"-18 FHN Z 120211549 1136104 6.9000 6.90
Received By Tax Exemption Subtotal 74.36
0031201550-020 G Shipping&Handling 0.00
Comments IN State Tax 0.00
County Tax 0.00
Contact:Brad Henderson City Tax 0.00
Total 74.36
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: ININ817330 Cust: ININ80003
VOUCHER NO. WARRANT NO.
Fastenal ALLOWED 20
IN SUM OF$
P. O. Box 1286
Winona, MN 55987-0978
$74.36
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#lrITLE AMOUNT� u T Board Members
2201 I ININ817330 1 43-500.801 $74.36 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
Ua" r
104Yc 0, 0 5
het rnrnmisgioner
Street Commissioner
I
Title
Cost distribution ledger classification if
claim paid motor 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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
i
Payee
Purchase Order No.
Terms
i
Date Due
Invoice Invoice ' Description Amount
Date Number (or note attached invoice(s)or bill(s))
03/18/15 I N I N817330 $74.36
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
20
Clerk-Treasurer