202699 10/11/2011 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
ONE CIVIC SQUARE ON SITE SUPPLY
CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101 CHECK AMOUNT: $189.46
INDIANAPOLIS IN 46220
CHECK NUMBER: 202699
CHECK DATE: 10/11/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 31852 189.46 OTHER EXPENSES
p Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
912612011 31852
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.Q. Number Terms Rep Ship Via F.Q.B.
Net 30 MCC 9/26/2011
QTY Item Code Description U/M Price Each BIQ Prev. Invd Amount
3 WIN 1420 Center -Flow Hand Towels, 660 Sheets /RL, 6RL/C:S 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
18/15005
Subtotal $189.46
(fin -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 johnw @onsiteontime.com Total $189.46
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 10/3/2011
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/3/2011 31852 $189.46
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 Officer
VOUCHER 112559 WARRANT ALLOWED
357683 ti IN SUM OF
ON SITE SUPPLY
5546 SHOREWOOD DRIVE
SUITE 101 WATER INDIANAPOLIS, IN 46220 IDERATIONS
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
31852 01- 6200 -06 $189.46
Voucher Total $189.46
Cost distribution ledger classification if
claim paid under vehicle highway fund