252374 12/08/15 Fop''"• CITY OF CARMEL, INDIANA VENDOR: 357683
`•` CHECK AMOUNT: $"t""`286 97"
.;, Qb �• ONE CIVIC SQUARE ON SITE SUPPLY
49� ,_�; CARMEL, INDIANA 46032 8728 ROBBINS ROAD CHECK NUMBER: 252374
M�(TOM�L-0• INDIANAPOLIS IN 46268 CHECK DATE: 12/08/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 52970 286.97 OTHER EXPENSES
Invoice
8728 Robbins Road Date Invoice#
Indianapolis, IN 46268
12/1/2015 52970
Bill To . Ship To
City of Carmel Water Utilities City of Carmel Water Utilities
A/P Dept. Attn:Greg
3450 West 131 St. 3450 West.131 St.
Carmel, IN 46074 Carmel,IN 460..74
P.O..Number. Terms Rep. Ship _ Via. F.O.B.
Net 30 MCC 11/25/2015
QTY Item Code- Description U/M Price Each'. _B/O Prev. Invd Amount
3 WIN 1420 Center Flow Hand Towels,660 Sheets/RL,'6RL/CS CS J. 44.74 0 0 134.22
2 GPC 193-78. COMPACT CORELESS BATH Tl SSUE 2 PLY CS .55.75. 0 0- 111.50
18/1500S
1 IBS VALH3860K::. ROLL LINER 38X60 22MI 6/25 BLACK CS 41.25 0 0 41.25
- X1103 ® l , $286.97
--- -
_ :-0n-Site Supply is a-certified Small,Disadvantaged Business-(SDB),and 8(a)certified -
�l?hone# Fax# E-mail =-Sales Tai
317-259-7788 or 888-259=7788 -3177-259-7700 orders onsiteontime.com $286.57
VOUCHER # 153726 WARRANT# ALLOWED
357683 IN SUM OF $
ON SITE SUPPLY
5546 SHOREWOOD DRIVE
SUITE 101
INDIANAPOLIS, IN 46220
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO* INV# ACCT# AMOUNT Audit Trail Code
52970 01-6200-06 $286.97
I
I
it
Voucher Total $286.97
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
357683
ON SITE SUPPLY Purchase Order No.
5546 SHOREWOOD DRIVE Terms
SUITE 101 Due Date 12/2/2015
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/2/2015 52970 $286.97
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
Date Officer