178323 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
ONE CIVIC SQUARE ON SITE SUPPLY
CHECK AMOUNT: $268.44
CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101
INDIANAPOLIS IN 46220
CHECK NUMBER: 178323
CHECK DATE: 10/14/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 24366 178.96 OTHER EXPENSES
601 5023990 24392 89.48 OTHER EXPENSES
ri
Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
9/30/2009 24366
Bill To Ship To
City of Carmel Wastewater Utilities City of Carmel Wastewater Utilities
A/P Dept. Attn: Jerry
3450 West 131 St. 5484 East 126th St.
Westfield, IN 46074 Carmel, W 46033
P.O. Number Terms Rep Ship Via F.O.B.
Net 30 MCC 913012009
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
4 WIN 1420 Center -Flow Hand Towels, 660 Sheets/RL, 6RL /CS CS 44.74 0 0 178.96
Subtotal $178.96
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 joking @OnSiteOntime.com Total $178.96
Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
10/2/2009 24392
t
Bill To Ship To
City of Carmel Wastewater Utilities City of Carmel Wastewater Utilities
A/P Dept. Attw 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 10/2/2009
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
2 WIN 1420 Center -Flow Hand Towels, 660 Sheets/RL, 6RL/CS CS 44.74 0 0 89.48
Subtotal $89.48
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 $89.48
Prescribed by State Board of Accounts S 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 10/5/2009
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/5/2009 24366 $178.96
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 GOff r
;TOUCHER 093156 ARRANT ALLOWED
157683 IN SUM OF
ON SITE SUPPLY
5546 SHOREWOOD DRIVE
SUITE 101
INDIANAPOLIS, IN 46220 1�R;
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
24366 01- 6200 -03 $178.96
qK
Voucher Total g ��i, Ly-96
Cost distribution ledger classification if
claim paid under vehicle highway fund