242247 02/17/15 CITY OF CARMEL, INDIANA VENDOR: 355029
® ; ONE CIVIC SQUARE DIRTWORKS LLC CHECK AMOUNT: $"""`1,050.00'
CARMEL, INDIANA 46032 5925 E 122ND STREET CHECK NUMBER: 242247
CARMEL IN 46033 CHECK DATE: 02/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 13380 1,050.00 OTHER EXPENSES
Dirtworks, LLC
5925 East 122nd Street Invoice
Carmel, IN 46033
Phone # (317)428-8210 Fax # (317)846-0338 Da#e IL1VOlce
1/31/2015 13380
BlI To
City of Carmel Utilities
3450 West 131st Street
Westfield, IN. 46074
Due Date
3/]/2015
Date - Descrlpttion Qty Rate Amount
_ .. = _ .
1/7/2015 Ticket#262964, 126th&Carmel Dr by#70 1 20.00 20.00
1/9/2015 Ticket#262968, Westwood Dr by#70 1 20.00 20.00
1/13/2015 , Ticket#262972, Slop Bin by#70 3 20.00 60.00
Same by#72 2 20.00 40.00
Same by#145 1 20.00 20.00
1/14/2015 1 Ticket#262982, 13456 Versailles Dr by#70 4 20.00 80.00
1/20/2015 1 Ticket#363825, Slot Bin by#70 1 20.00 20.00
Same by#72 1 20.00 20.00
1/21/2015 Ticket#363838, Slop Bin by#145 5 20.00 100.00
Same by#201 4 30.00 120.00
Same by#70 3 20.00 60.00
Same by#72 2 20.00 40.00
1/22/2015 Ticket#135234, Shop by#70 1 20.00 20.00
1 Ticket_#135208,_Plant 4 by Fluid Waste-#17 2 50.00 100:00-
1/23/2015 bcket 4135240,Plant#4 Slop Bin by#145 3 20.00 60.00
Same by#70 2 20.00 40.00
Same by 472 2 20.00 40.00
1/28/2015 Ticket#133362,Plant#3 by FWS#V17 3 50.00 150.00
Ticket#133361, Crooked Stick Lane by#70 1 2 20.00 40.00
-If Your Account is 60 Days Past Due-----Your Account Will be Closed until
Payment Is Received! Total $1,050.00
lc U e $1;050.00
Prescribed by State Board of Accounts
Form No.301(Rev.1995) ACCOUNTS PAYABLE VOUCHER
TO
ADDRESS
Invoice Date Invoice Number Item Amount
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
Mo. Day Yr. Signature Title
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 15-11-10-1.6.
Mo. Day Yr. Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ACCT.
3 Jr5 CARMEL, INDIANA No.
Favor Of
59 � 5 � 1-.-)aVs�- 5�
l -TS-) +-1 33
Total Amount of Voucher $
Deductions
13 8'D
(D 3(o. pa
Amount of Warrant $ D52 ap
Month of Yr
VOUCHER RECORD Acct.
No.
Source of Supply
Water Treatment
Transmission and Dist.
Customer Accounts
Administrative and General
Operation-Maintenance
Utility Plant in Service
Constr.Work in Progress
Materials and Supplies
Customers Deposits
Total
Allowed
Board of Control
Filed
Official Title
BOYCE FORMS•SYSTEMS 1-800-382-8702 325