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244474 04/21/15 CITY OF CARMEL, INDIANA VENDOR: 092000 ® l ONE CIVIC SQUARE FASTENAL COMPANY CHECK AMOUNT: $'••"""•62.94' CARMEL, INDIANA 46032 PO BOX 1286 CHECK NUMBER: 244474 WINONA MN 55987-1286 CHECK DATE: 04/21/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4350080 ININ817606 62.94 STREET LIGHT REPAIRS FASTBINLO Remit to INVOICE Fastenal Company Page 1 of 1 P.O. Box 1286 Winona, MN 55987-1286 Invoice Date Invoice No. Cust.No. ININ80003 For billing questions 04/13/2015 ININ817606 Cust.P.O. Truck 57 1010 Kendall Court,Suite 3 Invoice Total Job No. WESTFIELD, IN 46074 62.94 USD Contract No. Phone 317-804-8035 Due Date Sold To Fax 317-804-8037 05/13/2015 Ship To CARMEL STREET DEPT. Picked up at branch 3400 W 131 ST ST 1010 Kendall Court,Suite 3 WESTFIELD, IN 46074-8267 WESTFIELD, IN 46074 This Order and Document is subject to the"Terms of Purchase" posted on www.fastenal.com. Line Quantity Quantity Quantity Control Part Price/ No Ordered Shipped Backordered Description No. No. Hundred Amount 1 6 6 0 5/16 B&G w/135SP DB TOPEST 0345853 439.0000 26.34 2 6 6 0 1/4 B&G w/135SP DB TOPEST 0345849 279.0000 16.74 3 100 100 0 5/16"-18 FHN Z 120203426 1136104 6.9000 6.90 4 100 100 0 5/16 X 1 FEND Z 220015263 1133213 12.9600 12.96 Received By Tax Exemption Subtotal 62.94 0031201550-020 G Shipping&Handling 0.00 IN State Tax 0.00 Comments County Tax 0.00 Contact:Brad Henderson City Tax 0.00 Total 62.94 Reasonable collection and attorneys fees will be No materials accepted for return without our permission. assessed to all accounts placed for collection. All discrepancies must be reported within 10 days. If you re-package or re-sell this product,you are required to maintain Please pay from this invoice. integrity of Country of Origin to the consumer of this product. Invoice: ININ817606 cust: ININ80003 VOUCHER NO. WARRANT NO. ALLOWED 20 Fastenal IN SUM OF$ P. O. Box 1286 Winona, MN 55987-0978 $62.94 , ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 2201 ININ817606 I 43-500.801 $62.94 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 6 rid 1 15 VVV Title I I, 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. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 04/13/15 I N I N 817606 $62.94 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