243194 3 /18/2015 y„r.FOAM
CITY OF CARMEL, INDIANA VENDOR: 355029
.�; ® �, ONE CIVIC SQUARE DIRTWORKS LLC
CHECKAMOUNT: $********80.00*
r, CARMEL, INDIANA 46032 5925 E 122ND STREET CHECK NUMBER: 243194
q,;,.�, CARMEL IN 46033 CHECK DATE: 03/18/15
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 13480 80.00 OTHER EXPENSES
Dirtworks, LLC
5925 East 122nd Street invoice
Carmel, IN 46033 lea � uo�lce#
Phone # (317)428-8210 Fax# (317)846-0338
2/28/2015 13480
City of Carmel Utilities
3450 West 131st Street
Westfield,IN.46074
D:ue Date
4/1/2015
Date C�ascl'�ptlon Okii~
2/5/2015 Ticket 3370267,Allman Dr by#70 1 20.00 20.00
2/18/2015 Ticket#401317,Eden Glen by#70 1 20.00 20.00
2/19/2015 Ticket#401334, 10715 Lakeshore Dr East by#70 1 20.00 20.00
Same by#72 1 20.00 20.00
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-If Your Account is 60 Days Past Due---Your Account Will be Closed until
Payment Is Received! Total $80.00
Balance ®tae $80.00
VOUCHER # 151138 WARRANT# ALLOWED
f� IN SUM OF $
3555029
DIRTWORKS LLC
5925 EAST 122ND STREET
CARMEL, IN 46033
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
sl
PO# INV# ACCT# AMOUNT Audit Trail Code
I
13480 01-6360-06 $80.00
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t
Voucher Total $80.00
J
Cost distribution ledger classification if
claim paid under vehicle highway fund
I
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
3555029
DIRTWORKS LLC Purchase Order No.
5925 EAST 122ND STREET Terms
y
CARMEL, IN 46033 Due Date 3/9/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/9/2015 13480 ; $80.00
i
i
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
I
Date fficer