181337 01/13/2010 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
ONE CIVIC SQUARE ON SITE SUPPLY
CHECK AMOUNT: $178.96
�.a CARMEL INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101
INDIANAPOLIS IN 46220 CHECK NUMBER: 181337
CHECK DATE: 1!1312010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 25008 178.96 MATERIALS SUPPLIES
V" invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
12/8/2009 25008
Bill To Ship To
City of Carmel WasteWater Utilities City of Cannel WasteWater Utilities
A/P Dept. Attn: Chris
3450 West 131 St. 5484 East 126th St.
Westfield, IN 46074 Carmel, IN 46033
P.O. Number Terms Rep Ship Via F.O.B.
Net 30 MCC 12/8/2009
QTY Item Code Description U/M Price Each B/0 Prev. Invd Amount
4 WIN 1420 Center -Flow Eland Towels, 660 Sheets /RL, 6RL /CS CS 44.74 0 0 178.96
Subtotal $178.96
On -Site Supply is a certified Small Disadvantaged Business (SDB)
Phone Fax E -mail Sales Tax (7.0 $o.00
317- 259 -7788 or 888- 259 -7788 317- 259 -7700 jo1mg @OnSiteOntime.com Total $178.96
VOUCHER 093919 WARRANT ALLOWED
357683 IN SUM OF
r ON SITE SUPPLY
5546 SHOREWOOD DRIVE Ktf4
SUITE 101 0.
INDIANAPOLIS, IN 46220
Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
25008 01- 6200 -03 $178.96
Voucher Total $178.96
Cost distribution ledger classification if
claim paid under vehicle highway f
ZO
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 bate 12/15/2009
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/15/2004 25008 $178.96
ry
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