240679 01/07/2015 Cqq
CITY OF CARMEL, INDIANA VENDOR: 00352077
d ONE CIVIC SQUARE FLUID WASTE SERVICES INC CHECK AMOUNT: $*****2,130.00*
r�J CARMEL, INDIANA 46032 Po Box 264 CHECK NUMBER: 240679
'MiroN ca NOBLESVILLE IN 46061 CHECK DATE: 01/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 WO-12626 2,130.00 OTHER EXPENSES
Fluid Waste Services, Inc. '��®'C�
P. O. Box 264
Noblesville, IN 46061 Date Invoice#
317 773-7996
12/3/2014 WO-12626
Bill To
City of Carel Water Utilities Customer P.O./Job# F.T.#
Carmel
3450 W. 131 st St
Westfield, IN 46074 DAN 1 11714A 638
Project Terms
Plant#5 2015 Due on receipt
Description Qty Rate Amount
Date of Work: 11/26/14 8:30 am 1 0.00 0.00
Site Contact : Dan Jenkins-317-716-3919
Site Address: Hazel Dell& 126th St.
FWS Crew:JG/RM
Units&Equipment: V-12
Water:NA
Disposal : Dirt Works-3 loads Customer Account
Ticket# 161042, 161073. 161095
Field Notes:Vac out Salt Pits at Plant 5 as directed-Cleaned out pump pit
after salt removal.
Plant#5-PROVIDE VACUUM TRUCK SERVICES TO REMOVE UNUSED
MATERIAL FROM SALT STORAGE PIT AS DIRECTED.
3 truckloads disposal
Vac Truck,Transport and Disposal Fees-Per Load 3 350.00 1.050.00
Disposal costs assumed by Carmel Water Utility
2 MAN CREW-Labor per load 3 360.00 1,080.00
PREP BY RCS
TERMS NET 3 0
ADD %LATE FEE 45 DAYS
please call with any questions 317-773-7996 Total $2,130.00
Payments/credits $o.00
Balance Due $2,130.00
.s�
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
352077
FLUID WASTE SERVICES Purchase Order No.
P. O. BOX 264 Terms
FISHERS, IN 46038 Due Date 12/9/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/9/2014 WO-12626 $2,130.00
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
Date Officer
I VOUCHER # 142480 WARRANT # ALLOWED
352077 IN SUM OF $
FLUID WASTE SERVICES
R. O. BOX 264 ;
S" IN -4663'8"
1
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
WO-12626 01-6360-03 $2,130.00
i
Voucher Total $2,130.00
Cost distribution ledger classification if
claim paid under vehicle highway fund