204783 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: 092000 Page 1 of 1
4,y ONE CIVIC SQUARE FASTENAL COMPANY
so. CARMEL, INDIANA 46032 PO BOX 1286 CHECK AMOUNT: $32.90
WINONAMN 55987 -1286 CHECK NUMBER: 204783
CHECK DATE: 12/20/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 86498 32.90 OTHER EXPENSES
i
EA Remit to INVOICE
FASTML Fastenal Company
P.O. Box 1286 Page 1 of 1
Winona, MN 55987 -1286
Date Invoice No.
Gust. No. ININ80004 For billing questions 12/05/2011 ININ86498
Cust. P.O. 430 Alpha Drive, Suite 300
Job No. WESTFIELD, IN 46074 Due Date Invoice Total
Contract No. QPA t 11179 United States Phone 317 -867 -5259 01/04/2012 32.90 USD
Fax 317- 867 -5394
Sold To
0006037 01 ABC-'368 "AUTO TO 1 1073 46074 -8 -06037
1 .19111111111111111 Ilrl„II,IIIIr1IIJl ,1111111111111111111111 Ship To
CARMEL UTILITIES CARMEL UTILITIES
3450 W 131 ST ST 3450 W 131 ST ST
CARMEL, IN 46074 WESTFIELD, IN 46074
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. N o. Hundred Amount
1 1 1 0 GFU /01GreaseFltUnblk GROZZZ 0425983 3,290.2100 32 -90 Y
Received By Tax Exemption Subtotal 32.90
MIKE Shipping Handling 0.00
Comments IN State Tax 0.00
County Tax 0.00
Contact: Mike Carmel Water City Tax 0.00
Total 32.90
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.
0006037 -01. 0018523 Invoice: ININ86498 cust ININ80004
i i
VOUCHER 113269 WARRANT ALLOWED
92000 WAYER IN SUM OF
FASTENAL OPERAMONS
P.O. BOX 1286
WINONA, MN 55987 -1286
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
86498 01- 6200 -06 $32.90
Voucher Total $32.90
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
92000
FASTENAL Purchase Order No.
P.O. BOX 1286 Terms
WINONA, MN 55987 -1286 Due Date 12/15/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/15/201' 86498 $32.90
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