186966 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
ONE CIVIC SQUARE ON SITE SUPPLY
CHECK AMOUNT: $52.50
CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101
INDIANAPOLIS IN 46220 CHECK NUMBER: 186966
CHECK DATE: 6/2312010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 26577 25.00 OTHER EXPENSES
601 5023990 26610 27.50 OTHER EXPENSES
o Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
6/9/2010 26577
Bill To Ship To
City of Carmel Water Utilities City of Carmel 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 6/9/2010
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
1 15440 Blue Shoe Cover With Non -Skid "Tread, 400 /CS CS 25.00 0 0 25.00
Subtotal $25.00
On -Site Supply is a certified Small Disadvantaged Business (SDB)
Phone Fax E -mail Sales Tax (7.0 $0.00
317- 259 -7788 or 888- 259 -7788 317 -259 -7700 orders@OnSlteOnti nexorn T®taI $25.00
OPT ,S Invoice
9,
4
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
6/1 i /2010 26610
Bill To Ship To
City of Carmel Water Utilities City of Carmel 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 6/11/2010
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
1 15440W/XL White polypropylene shoe cover non-skid extra. CS 27.50 0 0 27.50
large 400pc /cs
Subtotal $27.50
On -Site Supply is a certified Small Disadvantaged Business (SDB)
Phone Fax E -mail Sales Tax (7.0 $0.00
31.7- 259 -7788 or 888 259 -7788 317 -259 -7700 ordersnOnSiteGntime.com Total $27.50
VOUCHER 101855 WARRANT ALLOWED
357583 IN SUM OF
ON-SITE SUPPLY 4fo `TE.4?
5546 SHOREWOOD DRIVE
SUITE 101 0
INDIANAPOLIS, IN 46220 ;6 a
Z k n
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
26610 01- 6200 -06 $27.50
Voucher Total5:' E $27.50
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 6/15/2010
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/15/2010 26610 $27.50
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