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212325 08/28/2012 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1 `` • ONE CIVIC SQUARE ON SITE SUPPLY CHECK AMOUNT: $193.23 CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101 INDIANAPOLIS IN 46220 CHECK NUMBER: 212325 CHECK DATE: 8/28/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 601 5023990 35581 42 . 03 OTHER EXPENSES 601 5023990 35582 88 . 20 OTHER EXPENSES 601 5023990 35635 63 . 00 OTHER EXPENSES - Invoice 5544 Shorewood Drive, Suite 101 Date Invoice# Indianapolis, IN 46220 8/15/2012 35581 Bill To Ship To City of Carmel Water Utilities City of Carmel Water Utilities A/P Dept. Attn:Crrea 3450 West 131 St. 3450 West 131 St. Carmel, IN 46074 Carmel, IN 46074 W P.Q.Number Terms Rep Ship Via F.Q.B. Net 30 MCC 8/15/2012 QTY Item Code Description U/M Price Each B/Q Prev. Invd Amount I ESS BRSX62B Can Liners, 38X60, 22Mic, 150 1CS CS 42.03 0 0 42.03 Subtotal $42.03 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 orders@onsiteontime.com Total $42.03 Invoice 5546 Shorewood Drive, Suite 101 Date Invoice# Indianapolis, IN 46220 8/2012012 35635 Bill To Ship To City of Carmel Water Utilities City of Carmel Water Utilities A./P Dept. Attn: Bruce 3450 West 131 St. 3450 West 131 St. Carmel, IN 46074 Carmel, IN 46074 P.O. Number Terms Rep Ship Via F.O.B. Net 30 MCC 8/20/2012 QTY Item Code Description U/M Price Each B/O Prev.Invd Amount 60 EN95 D Battery, 12/BX EA 1.05 0 84 6100 Subtotal $6100 ,n-Site Supply is a certified Small Disadvantaged Business (SDB) $0.O0 Sales Tax (7.0%) Phone# Fax# E-mail T 17-259-7788 or 888-259-7788 31?259 7700 orders @,onsiteontime.com Total $63.n0 N'. �Y - q� Invoice 5546 Shorewood Drive, Suite 101 Date Invoice# Indianapolis, IN 46220 8/15/2012 35582 Bill To Ship To City of Carmel Water Utilities City of Carmel Water Utilities AtP Dept. Attn: Bruce 3450 West 131 St. 3450 West 131 St. Carmel, IN 46074 Carmel, IN 46074 P.Q. Number Terms Rep Ship Via F.Q.B. Net 30 MCC 8/15/2012 QTY Item Code Description U/M Price Each B/Q Prev. Invd Amount 84 EN95 D Battery, 12 1BX EA 1.05 60 0 88.20 Subtotal $88.20 ©n-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 orders @onsiteontime.com Total $88.20 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 8/21/2012 INDIANAPOLIS, IN 46220 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 8/21/2012 35581 $42.03 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 # 121877 WARRANT # ALLOWED 357683 IN SUM OF $ ON 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 35581 01-6200-06 $42.03 5035 1 ` &3M 35562 Voucher Total 1 19 Cost distribution ledger classification if claim paid under vehicle highway fund