224866 10/08/2013 �,qyf CITY OF CARMEL, INDIANA VENDOR: 092000 Page 1 of 1
ONE CIVIC SQUARE FASTENAL COMPANY
CARMEL, INDIANA 46032 PO BOX 1286 CHECK AMOUNT: $269.66
WINONA MN 55987-1286
CHECK NUMBER: 224866
CHECK DATE: 10/8/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4237000 ININ2162616 239 . 69 REPAIR PARTS
2201 4237000 ININ2162680 29 . 97 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. ININ20009 For billing questions 09/23/2013 ININ2162680
Cust. P.O. verbal 14775 Herriman Blvd
Job No. NOBLESVILLE, IN 46060 Due Date Invoice Total
Contract No. QPA# 11179 Phone (317)770-0649 10/23/2013 29.97 USD
Sold To Fax (317)770-4279
Ship To
CARMEL STREET DEPT. Picked up at branch
3400 W 131 ST ST 14775 Herriman Blvd
CARMEL, IN 46074-8267 NOBLESVILLE, IN 46060
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 4 4 0 7940 P100 FltrDsk Pr 120177410 1032392 749.2100 29.97 Y
Received By Tax Exemption Subtotal 29.97
Shipping & Handling 0.00
Comments IN State Tax 0.00
County Tax 0.00
Contact:JEFF STEWART City Tax 0.00
Total 29.97
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.
0006489-03-0020009 Invoice: ININ2162680 oust: ININ20009
® Remit to INVOICE
FASTBIML Fastenal Company
P.O. Box 1286 Page 1 of 1
Winona, MN 55987-1286
Date Invoice No.
Cust. No. ININ20009 For billing questions 09/20/2013 ININ2162616
14775 Herriman Blvd
Cust. P.O. Chemical Safety
Job No. NOBLESVILLE, IN 46060 Due Date Invoice Total
Contract No. QPA# 11179 Phone (317)770-0649 10/20/2013 256.47 USD
Sold To Fax (317)770-4279
0006489 01 AB 0.384 "AUTO 112 0 1057 46074-8-06469
11111'llllllllllllllllllll'I'lllll�Il�l�llllll�lllllll'I"I"1111 Ship To
CARMEL STREET DEPT. Picked up at branch
3400 W 131 ST ST 14775 Herriman Blvd
CARMEL, IN 46074-8267 NOBLESVILLE, IN 46060
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 2 2 0 9002 MedFullFaceResp 120179844 1032369 11,984.2800 239.69 T Y
Uit t a.ltn
Received By Tax Exemption Subtotal 239.69
i & Handlin
fou State Tax 16.78
Comments nty Tax
Contact:Ralph City Tax 0.00
Total 256.47 -
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.
0006489-01-0020007 Invoice: ININ2162616 Cust: ININ20009
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))
09/20/13 I N I N2162616 $239.69
09/23/13 I N I N2162680 $29.97
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 1286
Winona, MN 55987-0978
$269.66
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
2201 ININ2162616 42-370.00 $239.69 1 hereby certify that the attached invoice(s), or
2201 ININ2162680 42-370.00 $29.97 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
Thur y, t er 03, 2.013
IV
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund