251530 11/18/15 oi.
CITY OF CARMEL, INDIANA VENDOR: 092000
ONE CIVIC SQUARE FASTENAL COMPANY CHECK AMOUNT: $******"214.20*CARMEL, INDIANA 46032 PO BOX 978 CHECK NUMBER: 251530
WINONA MN 55987-0978 CHECK DATE: 11/18/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 819417 214.20 OTHER EXPENSES
® Remit to INVOICE
Fastenal Company
P.O. Box 1286 Page 1 of 1
JILS7EAMLWinona, MN 55987-1286 Invoice Date Invoice No.
09/24/2015 I N I N 819417
Cust. No. ININ80387 For billing questions
Cust. P.O. Jack 1010 Kendall Court, Suite 3 Invoice Total
Job No. WESTFIELD, IN 46074 214.20 USD
Contract No. QPA 13090 Phone 317-804-8035 Due Date
Fax 317-804-8037 10/24/2015
Sold To
0004317 01 AB 0.413 "AUT0 T2 0 1061 46280-2-04317
�IIII���lllllll�llllllll�llll�lllll�lllllllll�l��lll�l�l�llllllll Ship To
CARMEL WASTEWATER TREATMENT Picked up at branch
9609 HAZEL DELL PKWY 1010 Kendall Court, Suite 3
INDIANAPOLIS, IN 46280-2935 0.9
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 80 80 0 5/8"-11 Bras FHN 120232995 75120 102.1500 81.72 Y
2 80 80 0 S/S HCS 5/8-11X2 1/2 120216019 70313 165.6000 132.48 Y
Received By Tax Exemption Subtotal 214.20
0031201550-020 G Shipping & Handling 0.00
IN State Tax 0.00
Comments County Tax 0.00
Contact:Jack City Tax 0.00
Total 214.20
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.
I
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.
0004317-01-0013217 Invoice: ININ819417 Cust: ININ80387
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 Purchase Order No.
P.O. BOX 1286 Terms
WINONA, MN 55987-1286 Due Date 11/5/2015
Invoice Invoice Description
Date . Number (or note attached invoice(s) or bill(s)) Amount
11/5/2015 819417 $214.20
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
VOUCHER # 153510 WARRANT # ALLOWED
92000 IN SUM OF $
FASTENAL
P.O. BOX 1286
WINONA, MN 55987-1286
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
819417 01-6200-06 $214.20
Voucher Total $214.20
Cost distribution ledger classification if
claim paid under vehicle highway fund