219715 05/07/2013 CITY OF CARMEL, INDIANA VENDOR: 092000 Page 1 of 1
ONE CIVIC SQUARE FASTENAL COMPANY
CARMEL, INDIANA 46032 PO BOX 1286 CHECK AMOUNT: $27.74
?� MONA MN 55987-1286
„o CHECK NUMBER: 219715
CHECK DATE: 5/7/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 2158747 27 . 74 OTHER EXPENSES
® Remit to INVOICE
FASTENAL Fastenal Company
P.O. Box 1286 Page 1 of 1
Winona, MN 55987-1286
Date Invoice No.
Cust. No. ININ20169 For billing questions 03/28/2013 ININ2158747
14775 Herriman Blvd
Job No.O NOBLESVILLE, IN 46060 Due Date Invoice Total
Contract No. QPA# 11179 Phone (317)770-0649 04/27/2013 29.68 USD
Sold To Fax (317)770-4279
0007534 01 AB 0.384 -AUTO H7 0 1019 46032.2-07534
I'll'llll'llll"1'1'111'1'III"II'lllllllllllll„lllllllllll�llll Ship To
CARMEL UTILITIES Picked up at branch
1 CIVIC SQ 14775 Herriman Blvd
CARMEL, IN 46032-2584 NOBLESVILLE, IN 46060
I
This Order and Document is subject to the "Terms of Purchase" posted on www.fastenal.com.
Line Quantity Quantity Quantity Control Part Price/
No Ordered Shipped Backordered Description No. No. Hundred Amount
1 20 20 0 1/2"-13 FHN 316 S/S 120121596 1177714 42.4000 8.48 T Y
2 10 10 0 1/2-13X1.75HCS316S/S CQINK0001 1177210 126.0000 12.60 T Y
3 10 10 0 1/2-13X1 3/4S/S HCS 120110732 1170210 66.6000 6.66 T Y
Received By Tax Exemption Subtotal 27.74
Shipping & Handling 0.00
Comments IN State Tax
County Tax 0.00
Contact:Jimbo City Tax 0.00
Total
2771/
Reasonable collection and attorneys fees will be No materials accepted for return without our permission.
assessed to all accounts placed for collection. All discrepancies must be reported within 10 days.
If you re-package or re-sell this product, you are required to maintain Please pay from this invoice.
integrity ofCountry of Origin to the consumer of this product.
0007534.01.0023811 Invoice: ININ2158747 Cust: ININ20169
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
92000
FASTENAL Purchase Order No.
P.O. BOX 1286 Terms
WINONA, MN 55987-1286 Due Date 4/30/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/30/2013 2158747 $27.74
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 # 131491 WARRANT # ALLOWED
92000 IN SUM OF $
FASTENAL
P.O. BOX 1286
WINONA, MN 55987-1286
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
2158747 01-6200-04 $27.74
Voucher Total $27.74
Cost distribution ledger classification if
claim paid under vehicle highway fund