182036 02/03/2010 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
ONE CIVIC SQUARE ON SITE SUPPLY
,c CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101 CHECK AMOUNT: $146.72
N.42:27 f INDIANAPOLIS IN 46220 CHECK NUMBER: 182036
CHECK DATE: 2/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 25290 146.72 OTHER EXPENSES
I �O�. °11LGO'
invoice
5546 Shorewood Drive, Suite 101 Date Invoice*
Indianapolis, IN 46220
1/20/2010 25290
Bill To Ship To
City of Carmel Water Utilities City of Cannel Water Utilities
A/P Dept. Attn: Greg
3450 West 131 St. 3450 West 131 St.
Westfield, IN 46074 Westfield, IN 46074
P.O. Number Terms Rep Ship Via F.O.B.
Net 30 MCC 1/20/2010
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
2 WIN 1420 Center -Flow Hand Towels, 660 SheetsfRL, 6RL /CS CS 44.74 0 0 89.48
1 GPC 193 -78 COMPACT CORELESS BATH TI SSUE 2 PLY CS 57.24 0 0 57.24
18/1500S
s-7
Subtotal $146.72
On -Site Supply is a certified Small Disadvantaged Business (SDB)
Phone* Fax E mail Sales Tax (7.0 50.00
317 -259 -7788 or 888 -259- 7788 317 -259 -7700 orders @OnSiteOntime.com Total $146.72
VOUCHER 094195 WARRANT ALLOWED
356$3 IN SUM OF
ON SITE SUPPLY
5546 SHOREWOOD DRIVE �J
SUITE 101
INDIANAPOLIS, IN 46220 A,
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
25290 01- 6200 -06 $146.72
Voucher Total $146.72
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 1/25/2010
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/25/2010 25290 $146.72
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