221036 06/18/2013 CITY OF CARMEL, INDIANA VENDOR: 092000 Page 1 of 1
ONE CIVIC SQUARE FASTENAL COMPANY
ti �o CARMEL, INDIANA 46032 PO BOX 1286 CHECK AMOUNT: $223.09
as s� WINONANIN 55987-1286 CHECK NUMBER: 221036
CHECK DATE: 6/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 ININ811359 67 . 74 REPAIR PARTS
2201 4237000 ININ811362 155 . 35 REPAIR PARTS
® Remit to INVOICE
FASTBIML Fastenal Company
P.O. Box 1286 Page 1 of 1
Winona, MN 55987-1286
Date Invoice No.
Cust.No. ININ80003 For billing questions 06/11/2013 ININ811359
Cust.P.O. Truck 411 1010 Kendall Court, Suite 3
Job No. WESTFIELD, IN 46074 Due Date Invoice Total
Contract No. QPA#11179 Phone 317-804-8035 07/11/2013 67.74 USD
Fax 317-804-8037
Sold To
Ship To
CARMEL STREET DEPT. Picked up at branch
3400 W 131ST ST 1010 Kendall Court,Suite 3
WESTFIELD, IN 46074-8267 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 1 1 0 HOLE SAW 4 1/2[72L] LENOXX 57073 6,773.6900 67.74 Y
Received By Tax Exemption Subtotal 67.74
0031201550-020 G Shipping&Handling 0.00
Comments IN State Tax 0.00
County Tax 0.00
Contact:Mike Henricks City Tax 0.00
Total 67.74
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.
Invoice: ININ811359 Cust: ININ80003
® Remit to INVOICE
Fastenal Company
P.O. Box 1286 Page 1 of 1
Winona, MN 55987-1286
Date Invoice No.
Cust. No. ININ80003 For billing questions 06/12/2013 ININ811362
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 07/12/2013 155.35 USD
Sold To Fax 317-804-8037
Ship To
CARMEL STREET DEPT. CARMEL STREET DEPT.
3400 W 131ST ST 3400 W 131ST ST
WESTFIELD, IN 46074-8267 WESTFIELD, IN 46074
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 1 1 0 82-AG CNT SNK CS1/2B NORSEM 0310126 12,009.6900 120.10 Y
2 1 1 0 304 SS Rnd 1/4"x 3' 220005997 47723 646.0300 6.46 Y
3 1 1 0 3/4 S&D Drill Bit TOPEST 0316250 2,879.0300 28.79 Y
Received By Tax Exemption Subtotal 155.35
0031201550-020 G Shipping&Handling 0.00
IN State Tax 0.00
Comments County Tax 0.00
Contact:Mike Henricks City Tax 0.00
Total 155.35
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.
Invoice: ININ811362 Cust: ININ80003
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
06/11/13 I N I N811359 $67.74
06/12/13 I N I N 811362 $155.35
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
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fastenal
IN SUM OF $
P. O. Box 978
Winona, MN 55987-0978
$223.09
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT
Board Members
2201 ININ811359 42-370.00 $67.74 1 hereby certify that the attached invoice(s), or
2201 ININ811362 42-370.00 $155.35 bill(s) is (are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
a
Fr June 14, 2013
- Uao.,dl--
Street Comm loner
Street Gepprnissio'30r
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund