193187 12/22/2010 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
ONE CIVIC SQUARE ON SITE SUPPLY
0 CHECK AMOUNT: $42.03
CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101
INDIANAPOLIS IN 46220 CHECK NUMBER: 193187
CHECK DATE: 12/22/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 28591 42.03 OTHER EXPENSES
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5 546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, M 46220
12n12010 28591
Bill To Ship To
City of Camel 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 111712010
QTY Item Code Description U/M Price Each 8/0 Prev- Invd Amount
I ESS BRSX62B Can Liners, 38X60, 22Nfic, 150/CS CS 42,03 0 0 42.03
Subtotal $42.03
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@OnSitLOntime.com Total $42.03
VOUCHER 103639 WARRANT ALLOWED
357683 IN SUM OF
ON SITE SUPPLY
5546 SHOREWOOD DRIVE R
71
SUITE 101
INDIANAPOLIS, IN 46220
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
28591 01- 6200 -06 $42.03
Voucher Total $42.03
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 12/14/2010
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/14/201( 28591 $42.03
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 jj
Date Officer