251065 11/04/15 CITY OF® CARMEL, INDIANA VENDOR: 092000 l`
ONE CIVIC SQUARE FASTENAL COMPANY CHECK AMOUNT: $********36.29*
s_ CARMEL, INDIANA 46032 PO Box 978 CHECK NUMBER: 251065
WINONA MN 55987-0978 CHECK DATE: 11/04/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 ININ819661 36.29 REPAIR PARTS
FAS7EANLO
Remit to INVOICE
Fastenal Company Page 1 of 1
P.O. Box 1286
Winona,MN 55987-1286 Invoice Date Invoice No.
Cust.No. ININ80003
For billing questions 10/15/2015 ININ819661
Cust.P.O. truck 57 1010 Kendall Court,Suite 3 Invoice Total
Job No. WESTFIELD, IN 46074 36.29 USD
Contract No. Phone 317-804-8035 Due Date
Sold To
Fax 317-804-8037 11/14/2015
• .
Ship To
CARMEL STREET DEPT. Picked up at branch
3400 W 131 ST ST 1010 Kendall Court,Suite 3
WESTFIELD, IN 46074-8267 WESTFIELD, IN 46074
This Order and Document is subject to the"Terms of Purchase"posted on www.fastenal.com.
Line Quantity Quantity Quantity Control Part Price/
No Ordered Shipped Backordered Description No. No. Hundred Amount
1 4 4 0 S/S HCS 5/8-11 X 5 110051750 70323 503.2500 20.13
2 3 3 0 S/S HCS 5/8-11X5 1/2 110051750 70324 538.5000 16.16
Received By Tax Exemption Subtotal 36.29
0031201550-020 G Shipping&Handling 0.00
IN State Tax 0.00
Comments County Tax 0.00
Contact:Jim Bentley City Tax 0.00
i�
Total 36.29
Reasonable collection and attorneys fees will be No materials accepted for return without our permission.
assessed to all accounts placed for collection. All discrepancies must be reported within 10 days.
If you re-package or re-sell this product,you are required to maintain Please pay from this invoice.
integrity of Country of Origin to the consumer of this product.
Invoice: ININ819661 Cust: ININ80003
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fastenal
IN SUM OF$
P. O. Box 1286
Winona, MN 55987-0978
$36.29
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 ININ819661 42-370.00 $36.29 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
Thur y, e 2 15
-VV VV = - - --- 6
rt�rorrrmiir
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.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10/15/15 ININ819661 $36.29
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