220142 05/21/2013 CITY OF CARMEL, INDIANA VENDOR: 092000 Page 1 of 1
4� ONE CIVIC SQUARE FASTENAL COMPANY
CARMEL, INDIANA 46032 PO BOX 1286 CHECK AMOUNT: $9.98
WINONA MN 55987-1286 CHECK NUMBER: 220142
CHECK DATE: 5/21/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 810833 9 . 98 OTHER EXPENSES
® Remit to INVOICE
FASTBVAL Fastenal Company
P.O. Box 1286 Page 1 of 1
Winona, MN 55987-1286
Date Invoice No.
Cust. No. ININ80004 For billing questions 04/25/2013 ININ810833
Cust. P.O. 1010 Kendall Court, Suite 3
Job No. WESTFIELD, IN 46074 Due Date Invoice Total
Contract No. QPA# 11179 Phone 317-804-8035 05/25/2013 9.98 USD
Fax 317-804-8037
Sold To
0005484 01 AB 0.384 "AUTO H8 0 1025 46074-8-05484
IIII'lllllllllllll�lll'll'll'I'll'I'lllll'llll'lllllllll'I'llll�l Ship To
CARMEL UTILITIES Picked up at branch
3450 W 131ST ST 1010 Kendall Court, Suite 3
CARMEL, IN 46074 WESTFIELD, IN 46074
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 25 25 0 1/2"-13 FHN Z WEINK0002 1136110 8.6500 2.16 Y
2 20 20 0 HCS1/2-13x 2-1/4 Z5 120030041 110120383 39.1100 7.82 Y
Received By Tax Exemption Subtotal 9.98
0031201560-020 G Shipping & Handling 0.00
Comments IN State Tax 0.00
County Tax 0.00
Contact:Aldwin City Tax 0.00
Total 9.98
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-of-Country of-Origin-to the consumer of this product. _
0005484-01-0017059 Invoice: ININ810833 Cust: ININ80004
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 5/11/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/11/2013 810833 $9.98
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
s/.7//-) e"'
Date Officer
VOUCHER # 131550 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
810833 01-6200-06 $9.98
Voucher Total $9.98
Cost distribution ledger classification if
claim paid under vehicle highway fund