178142 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 092000 Page 1 of 1
ONE CIVIC SQUARE FASTENAL COMPANY
Jl CARMEL, INDIANA 46032 PO BOX 1286 CHECK AMOUNT: $153.86
WINONA MN 55987 -1286
CHECK NUMBER: 178142
CHECK DATE: 10/14/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4239032 ININ2133214 153.86 POSTS HARDWARE
Remit to INVOICE
FAat� Fastenal Company
P.O. Box 1286 Page 1 of 1
Winona, MN 55987 -1286
Date Invoice No.
For billing questions 09/25/2009 ININ2133214
14775 Herriman Blvd
Cust. No. ININ20009 NOBLESVILLE, IN 46060 Due Date Invoice Total
Cust. P.O. V- Damian United States 10/25/2009 153.86 USD
Job No. Phone (317)770 -0649
Sold To Fax (317)770 -4279
0009550 01 AB 0.360 "AUTO T6 1 1057 46074 -8 -09550
11111 11111111111111111 11111 1111111 11111111 �u�ru� "'�1�1� Ship To
CARMEL STREET DEPT. Picked up at branch
3400 W 131 ST ST 14775 Herriman Blvd
WESTFIELD, IN 46074 -8267 NOBLESVILLE, IN 46060
This Order and Document is subject to the "Terms of Purchase" posted on www.fastenal.com.
Line Quantity Quantity Quantity Control Part Price
No Ordered Shipped Backordered Description No. No. Hundred Amount
1 6 fi 0 GRANITES CART 2202 M
RASET 0136076 2,266.7200 136.00
2 4 4 0 G5 NOZZLE FOR 220Z RAMSET 0136077 287.6800 11.51
Fastenal now has the ability to email or fax invoices. To enroll please call 866- 880 -3278.
Received By Tax Exemption Subtotal 147.51
7771 G Shipping Handling 6.35
Comments IN State Tax 0.00
County Tax 0.00
City Tax 0.00
Total 153.86
Reasonable collection and attorneys fees will be No materials accepted for return without our permission.
assessed to all accounts placed for collection. All discrepancies must be reported within 10 days.
If you re- package or re -sell this product, you are required to maintain Please pay from this invoice.
integrity of Country of Origin to the consumer of this product.
000s55o•o1•0030513 Invoice. ININ2133214 Cust. ININ20009
I
Prescribed by State Board of Accounts City Form No. 2Q1 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
09/25/09 I N I N2133214 $153.86
1 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
20
Clerk Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fastenal
IN SUM OF
.P. O. Box 978
Winona, MN 55987 -0978
$153.86
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #/TITLE AMOUNT
Board Members
2201 ININ2133214 42- 390.32 $153.86 1 hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
Frida O r 09, 2009
a
Street Commi$sio t r
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund