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196041 03/29/2011 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1 ONE CIVIC SQUARE ON SITE SUPPLY INDIANA 46032 CARMEL, 5546 SHOREWOOD DRIVE SUITE 101 CHECK AMOUNT: $296.12 INDIANAPOLIS IN 46220 CHECK NUMBER: 196041 CHECK DATE: 3/29/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 29576 72.40 OTHER EXPENSES 601 5023990 29591 79.00 OTHER EXPENSES 601 5023990 29628 144.72 OTHER EXPENSES Invoice 5546 Shorewood Drive, Suite 101 Date invoice Indianapolis, IN 46220 3/21/2011 29628 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 iP P.O. Number Terms Rep Ship via F.O.B. Net 30 MCC 3/21/2011 QTY Item Code Description U/M Price Each B/O Prev. Invd Amount 1 GPC 143 -78 COMPACT CORE LESS BATH T1 SSUE 2 PL,Y CS 55.24 0 0 55.24 18 /15005 2 WIN 1420 Center -Flow Hand Towels, 660 Sheets/RL, 6RL /CS CS 44.74 0 0 89.48 Subtotal $144.72 On -Site Supply is a certified Small Disadvantaged Business (SDB) Phone Fax E -mail Sales Tax $0.00 317 -259 -7788 or 888- 259 -778$ 317 259 -7700 sales@OnSiteOntime.com Total $144.72 Invoice V. m ®ce 5546 Shorewood Drive, Suite 101 Date Invoice Indianapolis, M 46220 3/16/2011 29591. Bill To Ship To City of Carmel Water Utilities City of Carmel Water Utilities NP Dept. Attn: Bruce 1450 West 131 St. 3450 West 131 St. Cannel, IN 46074 Westfield, IN 46074 P.O. Number Terms Rep Ship Via F.O.B. Net 30 MCC 311611011 QTY Item Code Description U/M Price Each B/O Prev. Invd Amount I GOJ 7265 GoJo Multi -Green 2000ML, 4 Refills /CS CS 79.00 0 0 79.00 Subtotal $79.00 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 sales @OnSitcOntime.com Total $79.00 Invoice 5546 Shorewood Drive, Suite 101 Date Invoice Indianapolis, IN 46220 3/15/2011 29576 Bill To Ship To City of Carmel Water Utilities City of Cannel Wastewater Utilities A/P Dept. Attn: Jerry 3450 West 131 St. 5484 bast 126th St. Carmel, IN 46074 Carmel, IN 46033 P.O. Number Terms Rep Ship Via F.O.B. Net 30 MCC 3 /15 /2011 QTY Item Code Description U/M Price Each B/O Prev. Invd Amount 12 S4175S Blue Mirror- Iiardcoated, Safety Glass PR 1.43 0 0 17.16 1 GPC 193 -78 COMPACT CORELESS BATH TI SSUE 2 PLY CS 55.24 0 0 55.24 18 /15005 Subtotal $72.40 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 sales@ OnSite©ntime.com 9 ®tall $72.40 VOUCHER 104403 WARRANT ALLOWED 357683 IN SUM OF ON SITE SUPPLY 5546 SHOREWOOD DRIVE WATJ�p SUITE 101 OO ER nojv s INDIANAPOLIS, IN 46220 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 29576 01-6200-03 $72.40 aq 591 u7cb -tL M-Cc� Voucher Total 09 1 Z 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 3/21/2011 INDIANAPOLIS, IN 46220 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 3/21/2011 29576 $72.40 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