247255 07/15/15 ; CITY OF CARMEL, INDIANA VENDOR: 00352077
(� ONE CIVIC SQUARE FLUID WASTE SERVICES INC CHECK AMOUNT: $*****2,500.00*
+. CARMEL, INDIANA 46032 PO Box 264 CHECK NUMBER: 247255
NOBLESVILLE IN 46061 CHECK DATE: 07/15/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 WO-14122 2,500.00 OTHER EXPENSES
Fluid Waste Services, Inc. Invoice
P. O. Box 264
Noblesville, IN 46061
Date Invoice#
317 773-7996
6/18/2015 WO-14122
Bill To
CITY OF CARMEL UTILITIES Customer P.O./Job# F.T.#
9609 HAZELDELL PKWY
INDIANAPOLIS.IN 46280 S15187 2146
I
Project Terms
11314 Rolling Springs Dr. Net 30
Description Qty Rate Amount
Date of work:Thursday 6-18-15 1 0.00 0.00
Site Contact:Calvin Cooper 317-716-3941
Site Address+: 11314 Rolling Springs Dr.Carmel, IN - -
FWS Crew:JG/BU/AR/JM
Units&Equipment:C-24,PPV,T-09
Water:Indy- 1
Disposal :NA
Field Notes:
Pipeline Rehab Services with a 8 inch x 4 ft.CIPP Sectional Liner
in the Rolling Springs Subdivision. 1 1314 Rolling Springs Dr.
USMH SMH499
DSMH SMH494
Break 35 ft.from USMH SMH499
Install an 8 inch x 4 ft.CIPP Sectional Liner 1 2,500.00 2,500.00
A pre-install video inspection is included in the cost of the liner.
PREP BY RCS
Thank you for your business-we appreciate it very much! Please reference Invoice#on remittance.
Total $2,500.00
Payments/Credits 50.00
Balance Due $2,500.00
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 7/8/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/8/2015 WO-14122 $2,500.00
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 # 155866 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-14122 01-7360-02 $2,500.00
Voucher Total $2,500.00
Cost distribution ledger classification if
claim paid under vehicle highway fund