246274 06/1 7/1 5 s�� ��• CITY OF CARMEL, INDIANA VENDOR: 355029
® ONE CIVIC SQUARE DIRTWORKS LLC CHECK AMOUNT: $*******180.00*
�. CARMEL, INDIANA 46032 5925 E 122ND STREET CHECK NUMBER: 246274
v�, �: CARMEL IN 46033 CHECK DATE: 06/17/15
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DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 14041 180.00 OTHER EXPENSES
Dirtworks, LLC
5925 East 122nd Street Invoice
Carmel, IN 46033 Date lruorce
Phone # (317)428-8210 Fax# (317)846-0338
5/31/2015 14041
�t11 To
City of Carmel Utilities
3450 West 131st Street
Westfield,IN.46074
Due � fe
7/1/2015
Date DesCrzpfron Qty Rate Amaunt
5/8/2015 Ticket#235344, Slot Bins by#70 1 20.00 20.00
Same by#145 2 20.00 40.00
Same by#72 2 20.00 40.00
Ticket 4235385, Carmel Water by#205 2 30.00 60.00
5/29/2015 Ticket#445331,Whisper Bay Ct 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 $180.00
Balance Due $180:00
VOUCHER # 152085 WARRANT# ALLOWED
3555029
IN SUM OF $
DIRTWORKS LLC
5925 EAST 122ND STREET
CARMEL, IN 46033
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Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
i� Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
14041 01-6360-06 $180.00 J'
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Voucher Total $180.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
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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
3555029
DIRTWORKS LLC Purchase Order No.
5925 EAST 122ND STREET Terms
CARMEL, IN 46033 Due Date 6/9/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/9/2015 14041 $180.00
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