165905 11/12/2008 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
I: 0 ONE CIVIC SQUARE ON SITE SUPPLY
CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101 CHECK AMOUNT: $403.55
INDIANAPOLIS IN 46220 CHECK NUMBER: 165905
CHECK DATE: 11/12/2008
DEPARTMENT ACCOU PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 21618 149.47 OTHER EXPENSES
601 5023990 21619 39.62 OTHER EXPENSES
601 5023990 21620 214.46 OTHER EXPENSES
I
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1
InV ®ICS
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
10/30/2008 21618
Bill To Ship To
City of Carmel Wastewater Utilities City of Carmel Wastewater Utilities
A/P Dept. Attn: Greg
3450 West 131 St. 3450 West 131 St.
Westfield, IN 46074 Westfield, IN 46074
P.O. Number Terms Rep Ship Via F.O.B.
Net 30 MCC 10/30/2008
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
1 3656 -L Thermo Lined Split Cowhide Gloves 6DZ/CS Size DZ 38.61 0 0 38.61
Large
1 3656 -XL Thermo Lined Split Cowhide Gloves 6DZ/CS Size XL DZ 40.56 0 0 40.56
2 WIN 1420 Center -Flow Hand Towels, 660 Sheets/RL, 6RUCS CS 35.15 0 0 70.30
Subtotal $149.47
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 Johng @OnSiteOntime.com Total $149.47
y Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
10/30/2008 21619
Bill To Ship To
City of Carmel Wastewater Utilities City of Cancel Wastewater Utilities
A/P Dept. Attn: Pemiy
3450 West 131 St. 3450 West 131 St.
Westfield, IN 46074 Westfield, IN 46074
P.O. Number Terms Rep Ship Via F.O.B.
Net 30 MCC 10/3012008
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
3 1ANS 34725M VERSATOUCH CLEAR VINYL GLOVE POWDER BX 4.79 0 0 14.37
FREE 100/DP
5 ANS 34700L LG VERSATOUCH GLOVE C R VINYL POWDER 5.05 0 0 25.25
100/DP
Subtotal $39.62
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 Johng @OnSiteOntime.com Total $39.62
Invoice
5
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
10/30/2008 21620
Bill To Ship To
City of Carmel Wastewater Utilities City of Cannel Wastewater Utilities
A/P Dept. Attn: Greg
3450 West 131 St. 3450 West 131 St.
Westfield, IN 46074 Westfield, IN 46074
P.O. Number Terms Rep Ship Via F.O.B.
Net 30 MCC 10/30/2008
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
4 475358 V-Gard Hard Hat, Fas-Trac Suspension, White EA 10.46 0 0 41.84
12 475359 MSA V-Gard w/Fast Trac Suspension BLUE EA 10.46 0 0 125.52
2 C 16002F /2XL Fluorescent Orange Class 2 Saftey Vest 2XL EA 7.85 0 0 15.70
2 C 16002F/3XL Fluorescent Orange Class 2 Saftey Vest 3XL EA 7.85 0 0 15.70
2 C16002F/L Fluorescent Orange Class 2 Saftey Vest Large EA 7.85 0 0 15.70
Subtotal $214.46
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 Johng @OnSiteOntime.com Total $214.46
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 11/3/2008
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/3/2008 21620 $214.46
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 O r
VOUCHER 08355E WARRANT ALLOWED
357683 IN SUM OF
ON SITE SUPPLY t3
5546 SHOREWOOD DRIVE
SUITE 101 0
INDIANAPOLIS, IN 46220 ZRI�
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
21620 01- 6200 -06 $214.46
D Ile l O1 u'avl Flo Zrj :16;�;z
1 uk'? cl (,Dm D(-. I L-I C? Ll 7
Voucher Total q D3, 55
Cost distribution ledger classification if
claim paid under vehicle highway fund