191306 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
0 ONE CIVIC SQUARE ON SITE SUPPLY CHECK AMOUNT: $280.94
CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101
INDIANAPOLIS IN 46220 CHECK NUMBER: 191306
CHECK DATE: 10/27/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 27925 236.20 MATERIALS SUPPLIES
601 5023990 28043 44.74 28043
Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
1.0/7 /2010 27925
Bill To Ship To
City of Carmel Water Utilities City of Carmel WasteWater Utilities
A/P Dept. Attn: Jerry
3450 West 131 St. 5484 East 126th St.
Carmel, IN 46074 Carmel, IN 46033
P.O. Number Terms Rep Ship Via F.O.B.
Net 30 MCC 1017 12010
QTY Item Code Description U/M Price Each B10 Prev. Invd Amount
4 WIN 1420 Center -Flow Fland Towels, 660 Sheets/RL, 6RL /CS CS 44.74 0 0 17896
1 GPC 193 -78 COMPACT CORELESS BATII Tl SSUE 2 PLY CS 57.24 0 0 57.24
1811500S
Subtotal $236.20
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 @OnSiteOntime -com Total $236.20
Invoice
5546 Shorewood Drive, Suite 101 Date Invoice#
Indianapolis, IN 46220
10/15/2010 28043
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.
Cannel, IN 46074 Carmel, IN 46074
P.O. Number Terms Rep Ship Via F.O.B.
Net 30 MCC 111111120111
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
I WIN 1420 Center- Flow.14and Towels, 660 SheetsAU.,, 6RL /CS CS 44.74 0 0 44.74
!N
Subtotal 544.74
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@ OnSiteOntime.com Total $44.74
VOUCHER 103041 WARRANT ALLOWED
357683 IN SUM OF
ON SITE SUPPLY
5546 SHOREWOOD DRIVE U)
SUITE 101
INDIANAPOLIS, IN 46220
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
28043 01- 6200 -06 $44.74
(n
Voucher Total
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 10/18/2010
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/18/201( 28043 $44.74
I hereby certify that the attached invoice(s), or bills) is (are) true and
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer