319860 12/21/17 CITY OF CARMEL, INDIANA VENDOR: 357683,;,
4
r ONE CIVIC SQUARE ON SITE:SUPPLY CHECK AMOUNT: $'*...***96.75*
CARMEL, INDIANA 46032 8728 ROBBINS ROAD CHECK NUMBER: 319860
9 .,_.. INDIANAPOLIS IN 46268 CHECK DATE: 12/21/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER_ AMOUNT DESCRIPTION
601 5023990 65666 96.75 OTHER EXPENSES
VOUCHER NO. 173616 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995)
ALLOWED' 20
Vendor # 357683 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
ON SITE SUPPLY CITY OF CARMEL
8728 ROBBINS RD An invoice or bill to be properly itemized must show: kind of service, where performed,
INDIANAPOLIS, IN 46268 dates service rendered, by whom, rates per day, number of hours,'rate per hour,
numbers of units, price per unit, etc.
Payee
96.75 357683 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR ON SITE SUPPLY Terms
Carmel Water Utility 8728 ROBBINS RD Due Date
BOARD MEMBERS
I hereby certify that that attached invoice(s),
INDIANAPOLIS, IN 46268
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
65666 01-6200-03 $96.75 and received except 12/11/2017 65666 $96.75
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. , 20_
Clerk-Treasurer
_® Invoice
8728 Robbins Road Date Invoice#
Indianapolis, IN 46268
12/11/2017 65666
Bill To Ship To
City of Carmel Water Utilities City of Carmel Water Utilities
A/P Dept. Attn:Jerry
3450 West 131 St. 4915 E 106TH ST
Carmel, IN 46074 Carmel,IN 46033
P.O. Number Terms Rep Ship Via F.O.B.
Net 30 MCC 11/30/2017
QTY Item Code Description U/M Price Each B/O Prey. Invd Amount
1 NP-58596 Bathroom Tissue,2 Ply,500 Sheets/RL,96 Rolls per CS 41.00 0 0 41.00
Case,48,000 Sheets in Case
1 GPC193-75B Compact Coreless Bath Tissue,2-Ply,White, 1000 CS 55.75 0 0 55.75
Sheets/Roll,36/Carton
Subtotal $96.75
On-Site Supply is a certified Small Disadvantaged Business(SDB),and 8(a)certified
Phone# Fax# E-mail Sales Tax (7.0%) $0.00
317-259-7788 or 888-259-7788 317-259-7700 orders@onsiteontime.com Total $96.75
Packing Slip
8728 Robbins Road Date S.O. No.
Indianapolis, IN 46268
11/30/2017 182694
Ship To
City of Carmel Water Utilities
Attn:Jerry
4915 E 106TH ST
Carmel,IN 46033
P.O. No. Ship Date Ship Via FOB
11/30/2017
Item Description Ordered Previous Shipped U/M Shipped
NP-58596 Bathroom Tissue,2 Ply,500 Sheets/RL,96 Rolls 1 0 CS 1
per Case,48,000 Sheets in Case
GPC193-75B Compact Coreless Bath Tissue,2-Ply,White, 1 0 CS 1
1000 Sheets/Roll,36/Carton
>`
Signature
Phone# Fax# E-mail Web Site
317-259-7788 or... 317-259-7700 orders@onsiteontime.com www.OnSiteOnTime.com