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237395 09/23/14
Coq . CITY OF CARMEL, INDIANA VENDOR: 368697 ® I ONE CIVIC SQUARE GROUNDBREAKERS CHECK AMOUNT: $*****3,410.00* �. ?� CARMEL, INDIANA 46032 5150 E 65TH SUITE B CHECK NUMBER: 237395 'M«ON�� INDIANAPOLIS IN 46220-4817 CHECK DATE: 09/23/14 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 4350900 880 3,410.00 OTHER CONT SERVICES HYDRO VAC SERVICES, LLC dba GROUNDBREAKERS 5150 E. 65th ST SUITE B INDIANAPOLIS, IN 46220-4817 317 284-1195 Invoice 880 Bill to: Job: 140270 CITY OF CARMEL HYDRO-CITY OF CARMEL BOARD OF PUBLIC WORKS& SAFETY VARIOUS LOCATIONS ONE CIVIC SQUARE CARMEL, IN 46032 CARMEL, IN Invoice- 880 Date: 07/18/14 Customer P.O. #: ----- ---------------------------------- ---------- Payment Terms: NET 60 Salesperson: Customer Code: 336 Remarks: �gpfxjgz --k : .._ 8.000 HYDRO VAC W/CREW HR 215.00 1,720.00 2.000 HYDRO VAC W/CREW OT HR 245.00 490.00 1.000 DUMP FEE EA 50.00 50.00 1.000 BACKFILL RESTORATION LS 1,150.00 1,150.00 Subtotal: 3,410.00 Total: 3,410.00 Print Date: 08/12/14 Page: 1 'Gro6ndbreakers, LLC ,Na 2169 1-888-777-3241 Hydro-Excavation Activity Sheet Date: � �© � � ( Truck No.: Customer: �� '� - Project No.: Operator: �' (>,�1 lS Laborer: Time On-Site Work Location /Sco/pe of Work City, State Rate Hours S u btota 10 n-site Mobilization G—G Demobilization Subtotal Mob/Demobj` _ m Time at Landfill: Hours Total No. Loads of Soil Disposed: J q' j`i D' Disposal Facility (Include City and State): 11 Notes/Comments W i iz a " /O Groundbreakers Signature/Date Customer S ignature/Date 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)) 07/18/14 880 $3,410.00 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 Hydro Vac Services, LLC/dba Groundbreakers IN SUM OF $ 5150 E. 65th Street,Suite B Indianapolis, IN 46220-4814 $3,410.00 ON ACCOUNT OF APPROPRIATION FOR Carmel DOCS PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members 1192 880 I 43-509.00 I $3,410.00 I 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 Monday, September 22, 2014 Director Title Cost distribution ledger classification if claim paid motor vehicle highway fund