204338 12/06/2011 "yF CITY OF CARMEL, INDIANA VENDOR. 357683 Page 1 of 1
j. ONE CIVIC SQUARE ON SITE SUPPLY
CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101 CHECK AMOUNT: $144.72
INDIANAPOLIS IN 46220
CHECK NUMBER: 204338
CHECK DATE: 12/612011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 32554 144.72 OTHER EXPENSES
t
Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 45220
1112912011 32554
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 1112912011
QTY Item Code Description U1M Price Each B10 Prev. Invd Amount
2 WIN 1420 Center -Flow Hand Towels, 660 SheetslRL, 6RUCS CS 44.74 0 0 89.48
1 GPC 193 -78 COMPACT CORELESS BATH TI SSUE 2 PLY CS 55.24 0 0 55.24
18/15005
Subtotal $144 -72
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 orders C@OnSiteOnTime.corn Total $144.72
VOUCHER 113083 WARRANT ALLOWED
357683 WA-M IN SUM OF
ON SITE SUPPLY OPERATIONS
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
32554 01- 6200 -06 $144.72
i
Voucher Total $144.72
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 11/30/2011
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/30/201' 32554 $144.72
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
-orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
4 1
Date Officer