199617 07/20/2011 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
ONE CIVIC SQUARE ON SITE SUPPLY
CHECK AMOUNT: $144.68
CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101
INDIANAPOLIS IN 46220 CHECK NUMBER: 199617
CHECK DATE: 7120/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 30850 144.68 MATERIALS SUPPLIES
Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
613012011 30850
Bill To Ship To
City of Carmel Water Utilities City of Carmel Water Utilities
AfP 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,0.13.
Net 30 MCC 613012011
QTY Item Code Description U1M Price Each B/O Prev. Invd Amount
2 WIN 1420 Center -Flow Hand Towels, 660 Sheets /RL, 6RL/CS CS 44.72 0 0 89.44
1 GPC 193 -78 COMPACT CORELFSS BATH TI SSUE 2 PLY CS 55.24 0 0 55 24
18 /1500S
Subtotal $144.68
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-T788 317- 259 -7700 orders @onsiteontime. Corn Total $144.68
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 7/12/2011
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/12/2011 30850 $144.68
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
VOUCHER 111747 WARRANT ALLOWED
357683 IN SUM OF
ON SITE SUPPLY
5546 SHOREWOOD DRIVE 9 ATM
SUITE 101 ATI;6w
INDIANAPOLIS, IN 46220
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Traii Code
30850 01- 6200 -06 $144.68
Voucher Total $144.68
Cost distribution ledger classification if
claim paid under vehicle highway fund