247219 07/15/15 CITY OF CARMEL, INDIANA VENDOR: 355029
® ONE CIVIC SQUARE DIRTWORKS LLC CHECK AMOUNT: $*******540.00*
,. �a CARMEL, INDIANq 46032 5925 E 122ND STREET CHECK NUMBER: 247219
+,;I�T�N�` CARMEL IN 46033 CHECK DATE: 07/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 14208 540.00 OTHER EXPENSES,
I
Dirtworks, LLC
5925 East 122nd Street i Invoice
Carmel, IN 46033
Phone # (317)428-921a Fax# (317).846-0338 Date ° �r uDtc
6/30/2015 14208
City of Carmel Utilities
3450 West 13Ist Street
Westfield,IN.4607.4
8/1/2015
Date Descn tlo� Rate Amount
P
6/2/2015 Ticket#021297,Brookshire&Somerset by#72 4 20.00 80.00
Same by#76 4 20.00 80.00
6/4/2015 Ticket#022216,Andundell Dr by 470 1 20.00 20.00
6/8/2015 Ticket#07988, 146th&John St by 4170 2 20.00 40.00
Same by 072 1 20.00 20.00
6/11/2015 Ticket#279762,Adios Pass by#70 1 20.00 20.00
6/12/2015 Ticket#279803, Shop by#70 3 20.00 60.00
Same by#145 3 20.00 60.00
Same by#72 3 20.00 60.00
6/22/2015 Ticket#481850,City Hall Roundabout by 470 1 20.00 20.00
6/23/2015 Ticket 41530664,2013 Stamhope St by 472 2 20.00 40.00
Same by#70 1 20.00 20.00
Ticket 4530665,City Hall'Roundabout by#145 1 20.00 20.00
EPayment
Account-is 60 DaysPast Due---Your Account Will be Closed until
Is Received! Total j $540.00
$540.00
lance Due,
VOUCHER # 152345 WARRANT# ALLOWED
3555029 IN SUM OF $
DIRTWORKS LLC
5925 EAST 122ND STREET
CARMEL, IN 46033
--------Carmel Water Utility -----ON ACCOUNT OF APPROPRIATION FOR
Board members
PO* INV# ACCT* AMOUNT Audit Trail Code
14208 01-6360-06 $540.00
i
Voucher Total $540.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 7/7/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/7/2015 14208 $540.00
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
711 1,s
Date Officer