214386 11/07/2012 CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
ONE CIVIC SQUARE ON SITE SUPPLY CHECK AMOUNT: $614.47
a CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101
INDIANAPOLIS IN 46220 CHECK NUMBER: 214386
CHECK DATE: 11/7/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 36448 152 . 93 OTHER EXPENSES
601 5023990 36449 425 .44 OTHER EXPENSES
601 5023990 36523 36 . 10 OTHER EXPENSES
Invoice
5546 Shorewood Dr Ste 101 Date Invoice#
Indianapolis,IN 46220
10/22/2012 36449
Bill To Ship To
City of Carmel Water Utilities City of Carmel Wastewater Utilities
A/P Dept Attn:Jerry
3450 West 131 St. 5484 East 126th St.
Carmel, IN 46074 Carmel, IN 46033
P.Q. Number Terms Rep Ship Via F.Q.B.
Net 30 MCC 10!2212012
QTY Item Code Description U1M Price Each BIQ Prev.Invd Amount
6 WIN 1420 Center-Flow Hand Towels,660 Sheets/RL, 6RL.J'CS CS 44.74 0 0 268.44
2 61156 Smoke Soap Dispenser W1Bottle EA 13.50 0 0 27.00
0 SAN T40OTBK CLASSIC CENTR-PULL TWL DISPNSRTRANS EA 36.10 1 0 0.00
PEARL BLCK
2 26800 Personal Smokers Cease-Fire, Gray EA 65.00 0 0 130.00
Subtotal $425.44
On-Site Supply is a certified Small Disadvantaged Business (SDB)
Phone# Fax# E-mail
Sales Tax (7.0%) $0.00
317-259-7783 or 888-259-7788 317-259-7700 orders c(Donsiteontime.com Total $425.44
On @ l Ii'1VoICe
5546 Shorewood Dr Ste 101 Date Invoice#
Indianapolis,IN 46220
10/2612012 36523
Bill To Ship To
City of Carmel Water Utilities City of Carmel Wastewater Utilities
A/P Dept. Attn:Jerry
3450 West 131 St. 5484 East 126th St.
Carmel, IN 46074 Carmel,IN 46033
P.O.Number Terms Rep Ship Via F.O.B.
Net 30 MCC 1012612012
QTY Item Code Description U/M Price Each B/O Prev.Invd Amount
0 WIN 1420 Center-Flow Hand Towels, 660 Sheets/RL,6RUCS CS 44.74 0 6 0.00
0 61156 Smoke Soap Dispenser W/Bottle EA 13.50 0 2 0.00
1 SAN T40OTBK CLASSIC CENTR-PULL TWL DISPNSRTRANS EA 36.10 0 0 36.10
PEARL BLCK
0 26800 Personal Smokers Cease-Fire, Gray EA 65.00 0 2 0.00
Subtotal $36.10
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 jol-ing @OnSiteOnTime.com Total $36.10
4 � Invoice
5546 Shorewood Dr Ste 101 Date Invoice#
1ndi;anapolis,IN 462_20
10/22/2012 36448
Bill To Ship To
City of Carmel Water Utilities City of Carmel Water Utilities
AIP Dept. Attn: Greg
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 10/22/2012
QTY Item Code Description UIM Price Each BIO Prev. Invd Amount
2 WIN 1420 Center-Flow Hand Towels, 660 SheetslRL,6RLICS CS 44.74 0 0
1 GPC 193-78 COMPACT CORELESS BATH TI SSUE 2 PLY CS 55.25 0 0 55.25
18/1500S
2 64005032 Lens Filter Sh. 12 5X5.25 EA 1.65 0 0 3.30
1 64005031 Lens Filter Sh. 13 4.50X5 25 EA 1.65 0 0 1.65
5 64005034 Clear Polycarbonate Lens 4.50x5.25 EA 0.65 0 0 3.25
Subtotal $152.93
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.corn Total $152.93
VOUCHER # 122564 WARRANT # , ALLOWED
357683 IN SUM OF $
ON SITE SUPPLY
5546 SHOREWOOD DRIVE
SUITE 101
INDIANAPOLIS, IN 46220
i'...f
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO* INV# ACCT# AMOUNT Audit Trail Code
36449 01-6200-03 $425.44
34 5�3 ►� � 3(�.1t3
3 Coa W g I.Lacb I Sa.93
Voucher Total q'7 4
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 10/29/2012
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/29/201; 36449 $425.44
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
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Date Officer