222384 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 092000 Page 1 of 1
ONE CIVIC SQUARE FASTENAL COMPANY
CARMEL, INDIANA 46032 PO BOX 1286 CHECK AMOUNT: $56.20
VMNONAMN 55987-1286 CHECK NUMBER: 222384
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 ININ811719 56 . 20 REPAIR PARTS
® 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 07/22/2013 ININ811719
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 08/21/2013 56.20 USD
Fax 317-804-8037
Sold To
Ship To
CARMEL STREET DEPT. Picked up at branch
3400 W 131 ST 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 60 30 30 3/8-16 X 2 S/S HCS 220001061 1170111 47.7000 14.31 Y
2 20 20 0 3/8-16 X 2 S/S HCS 120127933 1170111 47.7000 9.54 Y
3 100 100 0 3/8-16S/S NYLOCK 120117617 1170862 17.6500 17.65 Y
4 7 7 0 3/8-16x2-1/4 S/S HCS 220007691 1170112 54.4500 3.81 Y
5 20 20 0 3/8-16x2-1/4 S/S HCS 160061471 1170112 54.4500 10.89 Y
Received By Tax Exemption Subtotal 56.20
0031201550-020 G Shipping&Handling 0.00
IN State Tax 0.00
Comments County Tax 0.00
Contact:Steve Zeller City Tax 0.00
Total 56.20
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: ININ811719 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))
07/22/13 I N I N811719 $56.20
1 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 1286
Winona, MN 55987-0978
$56.20
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 1 ININ811719 1 42-370.001 $56.20 1 hereby certify that the attached invoice(s), or
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
` i a J , 2013
Stre�tr�# ��ner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
CITY OF CARMEL, INDIANA VENDOR: 092000 Page 1 of 1
ONE CIVIC SQUARE FASTENAL COMPANY
CARMEL, INDIANA 46032 PO BOX 1286 CHECK AMOUNT: $56.20
VMNONAMN 55987-1286 CHECK NUMBER: 222384
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 ININ811719 56 . 20 REPAIR PARTS
® 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 07/22/2013 ININ811719
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 08/21/2013 56.20 USD
Fax 317-804-8037
Sold To
Ship To
CARMEL STREET DEPT. Picked up at branch
3400 W 131 ST 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 60 30 30 3/8-16 X 2 S/S HCS 220001061 1170111 47.7000 14.31 Y
2 20 20 0 3/8-16 X 2 S/S HCS 120127933 1170111 47.7000 9.54 Y
3 100 100 0 3/8-16S/S NYLOCK 120117617 1170862 17.6500 17.65 Y
4 7 7 0 3/8-16x2-1/4 S/S HCS 220007691 1170112 54.4500 3.81 Y
5 20 20 0 3/8-16x2-1/4 S/S HCS 160061471 1170112 54.4500 10.89 Y
Received By Tax Exemption Subtotal 56.20
0031201550-020 G Shipping&Handling 0.00
IN State Tax 0.00
Comments County Tax 0.00
Contact:Steve Zeller City Tax 0.00
Total 56.20
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: ININ811719 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))
07/22/13 I N I N811719 $56.20
1 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 1286
Winona, MN 55987-0978
$56.20
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 1 ININ811719 1 42-370.001 $56.20 1 hereby certify that the attached invoice(s), or
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
` i a J , 2013
Stre�tr�# ��ner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund