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Home My WebLink About333492 12/14/18 e,q , y u' CITY OF CARMEL, INDIANA VENDOR: 092000 4� 4 °,• ONE CIVIC SQUARE FASTENAL COMPANY CHECK AMOUNT: $*******279.42* CARMEL, INDIANA 46032 PO Box 1286 CHECK NUMBER: 333492 WINONA MN 5 5987-1 28 6 CHECK DATE: 12/14/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4238900 ININ834278 279.42 OTHER MAINT SUPPLIES VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995) Vendor# 092000 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER FASTENAL COMPANY IN SUM OF$ CITY OF CARMEL PO BOX 1286 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. WINONA, MN 55987-1286 Payee $279.42 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Street Department Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT ININ834278 42-389.00 $279.42 1 hereby certify that the attached invoice(s),or 12/4/18 ININ834278 Supplies $279.42 2201 2201 2201 2201 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 Tuesday, December 11,2018 Huffman, Dave Director 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 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer ® Remit to INVOICE IF4 Fastenal Company Page 1 of 1 P.O. Box 1286 Winona, MN 55987-1286 Invoice Date Invoice No. 12/04/2018 I N I N 834278 Cust.No. ININ80003 For billing questions Invoice Total Cust.P.O. statue 1010 Kendall Court,Suite 3 Job No. WESTFIELD, IN 46074 279.42 USD Contract No. QPA 13090 Phone 317-804-8035 Due Date Fax 317-804-8037 01/03/2019 Sold To 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 8 8 0 8478SDEpxyAnchrSystm 120297390 2141217 3,492.7200 279.42 Y Received By Tax Exemption Subtotal 279.42 0031201550-020 G Shipping&Handling 0.00 IN State Tax 0.00 Comments County Tax 0.00 Contact:Jim Bentley City Tax 0.00 Total 279.42 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: ININ834278 cust: ININ80003 1 Packing Slip Reference DateNNpp.. Page FAWN", The store serving you is 12/4/18 ININ834278 1`. Cust. No. Cust. P.O. Job No. 1010 Kendall Court,Suite 3 DUE DATE:01/03/2019 ININ80003 statue WESTFIELD,IN 46074 Phone#:317-804-8035 Contract No: p Shlp To QPA 13090 SA/RdMEL STREET DEPT. Fax#:317-804-8037 k Pic ed up at Fastenal Store. 3400 W 131 ST ST WESTFIELD,IN 46074-8267 317-733-2001;317-733-2005(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 p No. Hundred 1 8 8 0 8478SDEpxyAnchrSystm 120297390 2141217 3,492.7200 279.42 G Received By Tax Exemption Subtotal 279.42 Shipping&Handling Comments This packing slip may State Tax Contact:Jim Bentley may be subject to County Tax tax depending on City Tax your status. TOTAL USD If 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 Zssessed to all ac�punts�placed forcollootipn o materials accepte or retu n without our permission. X indicates part is a hazardous material All discrepancies must be reported within 10 days. *19875* *indicates part was sold at a promotional or special discount price I IIIIII I III VIII VIII VIII IIII IIII FORM -INJ3