215383 12/11/2012 1
CITY OF CARMEL, INDIANA VENDOR: 357683 Page 1 of 1
`I. ONE CIVIC SQUARE ON SITE SUPPLY CHECK AMOUNT: $144.73
CARMEL, INDIANA 46032 5546 SHOREWOOD DRIVE SUITE 101
INDIANAPOLIS IN 46220 CHECK NUMBER: 215383
CHECK DATE: 12/11/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 36926 144 . 73 MATERIALS & SUPPLIES
Invoice
5546 Shorewood Dr Ste 101 Date Invoice#
Indianapolis, IN 46220
12/4/2012 36926
Bill To Ship To
City of Carmel Water Utilities City of Carmel Water Utilities
A/P 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 11/30/2012
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
1 GPC 193-78 COMPACT CORELESS BATH TI SSUE 2 PLY CS 55.25 0 0 55.25
18/15005
Subtotal $144.73
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 customerservice a onsiteontime.... Total $144.73
VOUCHER # 122958 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
36926 01-6200-06 $144.73
Voucher Total $144.73
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 12/4/2012
INDIANAPOLIS, IN 46220
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/4/2012 36926 $144.73
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