240851 01/07/15 Coq
r', ' '. CITY OF CARMEL, INDIANA VENDOR: 366767
d i, ONE CIVIC SQUARE VAN AUSDALL & FARRAR CHECK AMOUNT: $********55.32*
a CARMEL, INDIANA 46032 PO BOX 713683 CHECK NUMBER: 240851
M,4pNco, CINCINNATI OH 45271-3683 CHECK DATE: 01/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 63389 55.32 OTHER EXPENSES
Van AUSi all MAIL REMITTANCE TO: CONTRACT INVOICE
&Farrar VAN AUSDALL AND FARRAR,INC.
orrKxTxaawcr� PO BOX 71363,Cincinnati,OH 45271-3683 Invoice Number: 63389
sawroNs Phone(317)634-2913 Fax 638-1843
�'°" Invoice Date: 11/21/2014
Email invoicequestions to:.
billing@vanausdall.com
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Bill To: CITY OF CARMEL WATER PLANT 1! Cuomen. CITY OF CARMEL WATER PLANT 1
3450 W 131ST ST 3450 W 131ST ST
CARMEL,IN 46074 3 CARMEL,IN 46074
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511614 NETI10 12/01/201 $55.32 $ 55.32
16876-02: 317-57134141 $ 5 .32 08/27/2014 08/26/2015
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GIVE INVOICES TO WANDA j
Summary: I
Contract base rate charge for this billing period $0.00
Contract overage charge for the 08/27/2014 toy 11/26/2014 overage period $55.32**
*Sum of equipment base charges **See overage details below i $55.32
Detail:
FOR •• _s� 'sSur�r_a �;���ZiSJ!'_ ., ..r iti: �iTia
Number Serial Number i Base Charge Location
72261 V9735500993 i $0.00 CITY OF CARMEL WATER PLANT 13450 W 131ST ST
RICOH AFICIO MPC2051 f CARMEL,IN 46074
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Meter Type Meter Group Begin Meter End Meter Credits Total Covered Billable Rate Overage
B\W BW-16876-100 11,434 { 13,479 12,045 0 2,045 $0.005200 $10.63
Color CLR-16876-101 3,026 i 3,982 ( 956 0 956 $0.046750 $44.69
$55.32
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Customer Number:511614 Invoice Number:63389 Invoice SubTotal $55.32
Please Include Invoice Number on i emittance I Tax: $0.00
(
Invoice Total $55.32
Thank you for your business! Balance Due: $55.32
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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
317000
VAN AUSDALL & FARRAR INC Purchase Order No.
PO BOX 713683 Terms
CINCINNATI, OH 45271-3683 Due Date 12/2/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/2/2014 63389 $55.32
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
VOUCHER # 142395 WARRANT # ALLOWED
317000 IN SUM OF $
VAN AUSDALL & FARRAR INC
PO BOX 713683
CINCINNATI, OH 45271-3683
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
63389 01-6360-03 $55.32
Voucher Total $55.32
Cost distribution ledger classification if
claim paid under vehicle highway fund