178807 10/28/2009 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: $7.85
s 'ti•� c INDIANAPOLIS IN 46220
CHECK NUMBER: 178807
CHECK DATE: 10/28/2009
P ,EPARTMENT A CCOUNT PO NUM INVOICE NUMBER AMOUNT D
601 5023990 24381 7.85 OTHER EXPENSES
V4
Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
10/1/2009 24381
Bill To Ship To
City of Carmel Wastewater Utilities City of Carmel Wastewater Utilities
A/P Dept. Attn: Jamie
3450 West 131 St. 5484 East 126th St.
Westfield, IN 46074 Carmel, IN 46033
P.O. Number Terms Rep Ship Via F.O.B.
Net 30 MCC 10 /1 /2009
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
I SV2ZOM/5XL Safety_ Vest Orange, Class 2, XL EA 7.85 0 7.85
Subtotal $7.85
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 $7.85
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 10/20/2009
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/20/2005 24381 $7.85
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
Date Officer
VOUCHER 093354 WARRANT ALLOWED
3 IN SUM OF
0, SITE SUPPLY
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
24381 01- 6200 -03 $7.85
Voucher Total $7.85
Cost distribution ledger classification if
claim paid under vehicle highway fund