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CITY OF CARMEL, INDIANA VENDOR: 092000 w•■RIF•IFkONE CIVIC SQUARE FASTENAL COMPANYCHECK AMOUNT: S 28.80CARMEL, INDIANA 46032 PO Box 1286 CHECK NUMBER: 305977
WINONA NIN 55987-1286 CHECK DATE: 12/12/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 824681 28.80 OTHER EXPENSES
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® Remit to INVOICE
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Fastenal Company Page 1 of 1
P.O. Box 1286
Winona, MN 55987-1286 Invoice Date Invoice No.
11/16/2016 ININ824681
For billing questions Invoice Total
Cust.No. ININ80004 1010 Kendall Court, Suite 3
Cust P.O. shop WESTFIELD, IN 46074 28.80 USD
Job No. Due Date
Contract No. QPA 13090 Phone 317-804-8035
Fax 317-804-8037 12/16/2016
Sold To
000294101 AB 0.396 "AUTO T51 1073 46074-8-02943
IIII'III'tlllll"IIIIII�I�IIII'I"'IIII'II'IIIII"Illlllllllllllr Ship To
CARMEL UTILITIES Picked up at branch
3450 W 131ST ST 1010 Kendall Court, Suite 3
WESTFIELD, IN 46074 WESTFIELD, IN 46074
This Order and Document is subject to the "Terms of Purchase" posted on www.fastonal.com.
-_n-- ----- --- -- --- — -----
Line Quantity Quantity Quantity Control Part Price
No Ordered Shipped Backordered Description No. No. Hundred Amount
-1---5C50 0 1/2"-13 FHN Z 120260286 1136110 6.7300 3.37 Y
2 50 50 0 HCS1/2-13x3 Z 5 480003220 110120386 50.8500 25.43 Y
Received By Tax Exemption Subtotal 28.80
0031201560-020 G Shipping&Handling 0.00
IN State Tax 0.00
Comments County Tax 0.00
Contact:Steve Callahan City Tax 0.00
Total 28.80
m
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.
gIf 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: ININ824681 Cust: ININ80004
Packing Slip
FASM"' Reference
Date Page
The store serving you is ININs24681 1
Cust. No. Cust. P.O. Job No.
1010 Kendall Court,Suite 3 DUE DATE: 12/16/2016
ININ80004 shop
WESTFIELD,IN 46074
Phone#:317-804-8035 Contract No:
$pld T Fax#:317-804-8037 h!p TO
QPA 13090
CARMEL UTILITIES INP
up at Fas[enal Store.
3450 W 131ST ST
WESTFIELD,IN 46074
317-733-2855;317-733-2053(Fax)
This Order and Document are subject to the "Terms of Purchase"posted on www.fastenal.com.
Line Quantity Quantity Quantity Description Control Part No. Price/ Amount
No. Ordered Shipped Backorder No.
1 50 50 0 1/2"-13 FHN Z 120260286 1136110
2 50 50 0 HCS 1/2-130 Z 5 480003220 110120386
. V
Received By Tax Exemption Subtotal
Shipping&Handling
Comments State Tax
o
C on:act:Steer Callahan County Tax
City rax
TOTAL USD
it you re-package or re-sell this product,you are required to maintain
integrity of Country of Origin to the consumer of this product.
Reasonable collection and attorneys fees will be J
assessed to all accpunts placed for collectign
No materials accepted for return without our permission.
X indicates part is a hazardous material All discrepancies must be reported within 10 days. *14598*
*indicates part was sold at a promotional or special discount price 1111111 VIII VIII VIII VIII IIII IIII
FORM -IV13