235419 07/30/14 �qqM CITY OF CARMEL, INDIANA VENDOR: 141050
.j ONE CIVIC SQUARE INDEPENDENT CONCRETE PIPE CHECK AMOUNT: $*******124.20*
�, ?a CARMEL, INDIANA 46032 INDIANA DIVISION CHECK NUMBER: 235419
vMiroN.�` PO BOX 6457 DEPT 279 CHECK DATE: 07/30/14
INDIANAPOLIS IN 46206
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 21155 124.20 OTHER EXPENSES
COHC9 Independent Concrete Pipe Invoice
Qk► Fj, 2050 South Harding Street Number .................:ARS100021155
c Indianapolis,IN,46221 Date .....................: 7/14/2014
? Page ....................: 1 of 1
'^ Telephone : 317-262-4920 Sales order ..............:S00010818
Fax ........: 317-262-8011 Customer PO ...........
Customer number .......: IN0095
Sales rep ................:
Mode of delivery ........: Cust
Payment terms ..........: Net 30 days
Invoice account .........: IN0095
Customer Contact .......
Job description ..........•Sewer Dept Jeff Cooper
Sold to Ship to:
City Of Carmel City Of Carmel
3400 W. 131st Street Westfield, IN 46074
Westfield, IN 46074 US
US
Item number Wall Class Description Unit Quantity Unit price Amount
Packing slip:00039907 Ship date: 7/14/2014
Kent Seal Kent Seal Each 6.00 20.00 120.00
Fuel Surcharge% 4.20
Terms: Net 30. After expiration of this term,customer shall pay 8% Remit To Sales balance ... 120.00
interest, costs of collection,and attorney fees. Independent Concrete Pipe Misc.charges ... 4.20
PO Box 6457-Dept#279 Sales tax .......: 0.00
Indianapolis, IN 46206 Total 124.20
VOUCHER # 145178 WARRANT# ALLOWED
141050 IN SUM OF $
INDEP CONCRETE PIPE CO
PO BOX 6457 - DEPT#279
INDIANAPOLIS, IN 46206
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT#
AMOUNT 1 Audit Trail Code
ARS10002115 01-7200-02 $124.20
d
i
Voucher Total $124.20
Cost distribution ledger classification if
claim paid under vehicle highway fund
PA 1,361 Li �
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
141050
INDEP CONCRETE PIPE CO Purchase Order No.
PO BOX 6457- DEPT#279 Terms
INDIANAPOLIS, IN 46206 Due Date 7/24/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/24/2014 ARS1000211; $124.20
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