176878 09/02/2009 a CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
0 ONE CIVIC SQUARE ON SITE SUPPLY CHECK AMOUNT: $497.40
CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101
INDIANAPOLIS IN 46220 CHECK NUMBER: 176878
CHECK DATE: 9/2/2009
DEPARTMENT ACCOU PO NUMBER INVOICE NUMBER AMOUNT DES
601 5023990 23934 248.70 OTHER EXPENSES
601 5023990 23956 248.70 OTHER EXPENSES
a
Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
8/14/2009 23934
I Bill To Ship To
City of Cannel Wastewater Utilities City of Cannel 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 811412009
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
3 WIN 1420 Center -Flow Hand Towels, 660 Sheets/RL, 6RL/CS CS 44.74 0 0 134.22
2 GPC 193 -78 COMPACT CORELESS BATH TI SSUE 2 PLY CS 57.24 0 0 114.48
18/1500S
Subtotal $248.70
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 $248.70
Invoice
5546 Shorewood Drive, Suite 101 Date Invoice
Indianapolis, IN 46220
8/17/2009 23956
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 8/1712009
QTY Item Code Description U/M Price Each B/O Prev. Invd Amount
3 WIN 1420 Center -Flow Hand Towels, 660 Sheets/RL, 6RL/CS CS 44.74 0 0 134.22
2 GPC 193 -78 COMPACT CORELESS BATH T1 SSUE 2 PLY CS 57.24 0 0 114.48
18/1500S
Subtotal $248.70
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 @OnSiteOntiine.com Total $248.70
Prescribed by State Board of Accounts City Form No. 201 (Rev 19915)
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. 9
Payee l
357683
ON SITE SUPPLY Purchase Order No.
5546 SHOREWOOD DRIVE Terms
SUITE 101 Due Date 8/26/2009
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/26/2009 23934 $248.70
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
f
VOUCHER 092838 WARRANT ALLOWED
357683 �p,'[
IN SUM OF
ON SITE SUPPLY
5546 SHOREWOOD DRIVE �(ii CP
SUITE 101
INDIANAPOLIS, IN 46220
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO I NV ACCT AMOUNT Audit Trail Code
23934 01- 6200 -03 $248.70
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I Voucher Total 4 p
Cost distribution ledger classification if
claim paid under vehicle highway fund