180495 12/16/2009 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
ONE CIVIC SQUARE ON SITE SUPPLY
?o CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101 CHECK AMOUNT: $2,283.54
.oar' INDIANAPOLIS IN 46220 CHECK NUMBER: 180495
CHECK DATE: 12/16/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
-601 5023990 W09063 24943 327.94 BATHROOM SUPPLIES
2201 4356001 25005 1,955.60 UNIFORMS
On "Sloe Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
12/8/2009 25005
Bill To Ship To
City of Carmel Street Department City of Carmel Street Department
3400 West 131st. Street Attn: Jim Hobbs
Westfield, IN 46074 3400 West 131st. Street
Westfield, IN 46074
P.O. Number Terms Rep Ship Via F.O.B.
Net 30 MCC 121812009
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
25 SVL3M -M /L OK -1 Class 3 High Gloss 3M Tape, Lime, M/L EA 20.00 0 0 500.00
30 SVL3M -XL OK -1 Class 3 High Gloss 3M Tape, Lime, XL EA 20.00 0 0 600.00
15 SVL3M -2XL OK -1 Class 3 High Gloss 3M Tape, Lime, 2XL EA 20.00 0 0 300.00
5 SVL3M -3XL OK -1 Class 3 High Gloss 3M Tape, Lime, 3XL EA 22.00 0 0 110.00
10 475358 V -Gard Hard Hat, Fas -Trac Suspension, White EA 11.14 0 0 111.40
30 475361 MSA V Guard W /Fas -Trac Suspension Orange EA 11.14 0 0 334.20
Subtotal $1,955.60
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 johng @OnSiteOntime.com Total $1,955.60
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 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))
12/04/09 25005 $1,955.60
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
On -Site Supply
IN SUM OF
5446 Shorewood Drive, Suite 101
Indianapolis, IN 46220
$1,955.60
t,
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Member:
2201 25005 43- 560.01 $1,955.60 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
F7iday, December 1, 200
Street Commissioner
Stree'ti&ommissioner
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
12/2/2009 24943
Bill To Ship To
City of Carmel Wastewater Utilities City of Carmel Wastewater Utilities
A/P Dept. Attn: Greg
3450 West 131 St. 3450 West 131 St.
Westfield, IN 46074 Westfield, IN 46074
P.O. Number Terms Rep Ship Via F.O.B.
Net 30 MCC 12/2/2009
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
2 GPC 193 -78 COMPACT CORELESS BATH TI SSUE 2 PLY CS 57.24 0 0 114.48
18/1500S
2 WIN 1420 Center -Flow Hand Towels, 660 Sheets/RL, 6RL /CS CS 44.74 0 0 89.48
2 RCP J153 5X24 TRAPPER DUSTMOP 3 /CS EA 13.68 0 0 27.36
l ESS BRSX62B Can Liners, 38X60, 22Mic, 150 /CS CS 42.03 0 0 42.03
1 ESS BR3340X 33X40 RL LINER, I 7MIC, 10/ 25'S,CLR CS 36.46 0 0 36.46
3 T290OW -L Vinyl disposable glove industrial grade lightly BX 3.75 0 0 11.25
powdered
2 RCP 6310 WHI Toilet Bowl Brush EA 1.82 0 0 3.64
2 RCP 6311 WHI BOWL BRUSH HOLDER EA 1.62 0 0 3.24
Subtotal $327.94
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 johng @OnSiteOntime.com Total $327.94
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 12/7/2009
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/7/2009 24943 $327.94
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 093778 WARRANT ALLOWED
357683 IN SUM,OF
OR SITE SUPPLY
5546 SHOREWOOD DRIVE
SUITE 101
I NDIANAPOLIS, IN 46220
1 Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
24943 01- 6200 -06 $327.94
11
y Voucher Total $327.94
Cost distribution ledger classification if
claim paid under vehicle highway fund