192522 12/07/2010 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
0 ONE CIVIC SQUARE ON SITE SUPPLY CHECK AMOUNT: $146.72
CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101
INDIANAPOLIS IN 46220 CHECK NUMBER: 192522
CHECK DATE: 12/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 28477 146.72 OTHER EXPENSES
Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
1.1 /23/2010 28477
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.
Carmel, IN 46074 Carmel, IN 46074
P.O. Number Terms Rep Ship Via F.O.B.
Net 30 MCC 11/23/2010
QTY Item Code Description U/M Price Each B/O Prev. invd Amount
2 WIN 1420 Center -Flow Eland Towels, 660 Sheets/RL, 6RL /CS CS 44.74 0 0 89.48
1 GPC 193 -78 COMPACT CORELESS BATH'rl SSUE 2 PLY CS 57.24 0 0 57.24
18/1500S
Subtotal $146.72
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 @OuSIteOntlniexoni Total $1.46.72
VOUCHER 103448 WARRANT ALLOWED
357683 IN SUM OF
ON SITE SUPPLY
5546 SHOREWOOD DRIVE
SUITE 101 OP�
776N
INDIANAPOLIS, IN 46220
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
28477 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 11/30/2010
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/30/201( 28477 $146.72
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
Z 13 /4 vim'-:
Date Officer