197326 05/11/2011 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
ONE CIVIC SQUARE ON SITE SUPPLY CHECK AMOUNT: $613.79
CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101
INDIANAPOLIS IN 46220 CHECK NUMBER: 197326
CHECK DATE: 5/1112011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 29989 434.91 OTHER EXPENSES
601 5023990 30029 178.88 OTHER EXPENSES
Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
4/25/2011 30029
Bill To Ship To
City of Carmel Water Utilities City of Carmel Wastewater Utilities
A/P Dept. Ann: Jerry
3450 West 131 St. 5484 East 126th St,
Carmel, IN 46074 Cannel, IN 46033
P.O. Number Terms Rep Ship Via F.Q.B.
Net 30 MCC 4125/2011
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
4 WIN 1420 Center -Flow Hand Towels, 660 Sheets /RL, t)RL/CS CS 44.72 0 0 178.88
Subtotal $178.88
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 @OnSiteOntime.cum Total $178.88
Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
4/20/2011 29989
Bill To Ship To
City of Carmel Water Utilities City of Carmel Water Utilities
AAP Dept. Attn: Greg
3450 West 131 St. 3450 West 131 St,
Carmel, IN 46074 Carmel, IN 46074
P.C. Number Terms Rep Ship Via F.C.B_
Net 30 MCC 4/20/2011
CTY Item Code Description U[M Price Each BIC Prev. Invd Amount
12 STG5920S Endeavor Safety Glass, Gray Lens with Gray Temple EA 2.35 0 0 28.20
1 BLUSTORM Bluestorm Hand Dryer EA 319.94 0 0 319.94
1 WIN 1420 Center -Flow Hand Towels, 660 SheetslRL, 6RLlCS CS 44.74 0 0 44.74
1 ESS BRSX62B Can Liners, 38X60, 22Mic, 1501CS CS 42.03 0 0 4103
�r
Subtotal $434.91
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@OnSiteOntime.com Total $434.91
VOUCHER 111038 WARRANT ALLOWED
357683 IN SUM OF
ON SITE SUPPLY
5546 SHOREWOOD DRIVE
SUITE 101
INDIANAPOLIS, IN 46220
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
30029 01- 6200 -03 $178.88
Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 241 (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 4/28/2011
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/2812011 30029 $178.88
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
X/ C
Date Officer