240998 1 /13/2015 u_�4q
CITY OF CARMEL, INDIANA VENDOR: 00352077
I; b 'il ONE CIVIC SQUARE FLUID WASTE SERVICES INC CHECK AMOUNT: $*******323.75*
f. ,r° CARMEL, INDIANA 46032 PO Box 264 CHECK NUMBER: 240998
9y�TpN�°' NOBLESVILLE IN 46061 CHECK DATE: 01/13/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 WO-12762 323.75 OTHER EXPENSES
Fluid Waste Services, Inc. Invoice
P. O. Box 264
Noblesville, IN 46061 Date Invoice#
317 773-7996
12/15/2014 WO-12762
Bill To
CITY OF CARMEL UTILITIES Customer P.O./Job# F.T.#
9609 HAZELDELL PKWY
INDIANAPOLIS, IN 46280 S14653 803
US
Project Terms
375 Winding Way Net 30
Description Qty Rate Amount
Dafe of Work:Monday 12-15-14 1'. 0.00 0.00
SiteiContact Joe Faucett 317-116-305 _.
Site Address 3754Winding Way
FWS Crew: EM/BS
Unit&Equipment:T-21
Field Notes:
Televised(1) 10"sewer line to locate lateral as directed.
Televising Services Hourly Rate-no 2 hr minimum fee applied 1.75 185.00 323.75
pBG,aMM
I
TERMS NET 30
` ADD 5% ATE FEE AFTER 5 DAYS
'Thank you for your business'-we-appreciate it very much! Please reference Invoice#on remittance.
Total $323.75.
! •, 1r
Payments/Credits $0.00
Balance Due $323.75
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,INC. Purchase Order No.
PO BOX 264 Terms
Noblesville, IN 46061 Due Date 12/30/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/201, WO-12762 $323.75
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 # 146360 WARRANT # ALLOWED
352077 IN SUM OF $
FLUID WASTE SERVICES,INC.
PO BOX 264
Noblesville, IN 46061
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
WO-12762 01-7360-02 $323.75
Voucher Total $323.75
Cost distribution ledger classification if
claim paid under vehicle highway fund