194712 02/16/2011 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
ONE CIVIC SQUARE ON SITE SUPPLY CHECK AMOUNT: $334.18
sR CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101
INDIANAPOLIS IN 46220 CHECK NUMBER: 194712
CHECK DATE: 2/16/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 29132 189.46 OTHER EXPENSES
601 5023990 29170 144.72 OTHER EXPENSES
z. p Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, CN 46220
1/31/2011 29132
Bill To Ship To
City of Carmet 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 1/31/2011
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
3 WIN 1420 Center -Flow Hand `bowels, 660 SheetsM,, 6RL /CS CS 44.74 0 0 134.22
1 GPC 193 -78 COMPACT CORELESS BATH TI SSUE 2 PLY CS 55.24 0 0 55.24
18/1500S
Subtotal $189.46
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@OnSiteCmtime.com Total $189.46
Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
2/3/2011 29170
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 2/3/2011
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
2 WIN 1420 Center -Flow Hand Towels, 660 Sheets/RL, 6RUCS CS 44.74 0 0 89.48
1 GPC 193 -78 COMPACT CORLLESS BATH TI SSUE 2 PLY CS 55.24 0 0 55.24
18/1500S
Subtotal $144.72
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 ordersgOnSiteOntime.com. Total $144.72
VOUCHER 104029 WARRANT ALLOWED
357683 IN SUM OF
ON SITE SUPPLY op
5546 SHOREWOOD DRIVE9�
SUITE 101
INDIANAPOLIS, IN 45220
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
29170 01- 6200 -06 $144.72
Voucher Total 3 3�[. 44 2
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 2/7/2011
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/7/2011 29170 $144.72
hereby certify that the attached invoice(s), or bill(s) is (are) true and
orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer