247918 07/28/15 r Coq
CITY OF CARMEL, INDIANA VENDOR: 368572
® ONE CIVIC SQUARE KB INDUSTRIES INC CHECK AMOUNT: $""""3,610.98'
:• _� CARMEL, INDIANA 46032 BYRAN DAIRY EAST CHECK NUMBER: 247918
7300 BRYAN DAIRY ROAD,STE 4 CHECK DATE: 07/28/15
LARGO FL 33777
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350900 32554 12805 3,610.98 FLEXI-PAVE
KB Industries, Inc. oii"i�� __r - - Invoice
Bryan Dairy East ' �; I
7300 Bryan Dairy Rd N
Ste 400 L - ' k Date Invoice#
Largo, FL 33777 7/16/2016 12805
Bill To
City of Carmel Street Department
3400 West 131st Street
Carmel,IN 46074
P.O. No. Terms Project
Due on receipt Guilford Cando
Quantity Description Rate Amount
108 KBI Flexi-Pave HD2000-Black 5.95 642.60
48 KBI Flexi Pave HD2000-Black(linear foot) 23.80 1,142.40
108 KBI Flexi Pave lostallation 3.00 324.00
48 KBI Flexi-Pave Installation(linear foot) 10.42 500.16
Freight Charges 606.82 606.82
Corporate Mobilization 395.00 395.00
Sales Tax 7.00% 0.00
Total $3,610.98
Fed Tax ID 02.0653997
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
07/16/15 12805 $3,610.98
I hereby certify that the attached invoice(s), or bili(s), is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
20
Clerk-Treasurer
VOUCHER NO. WARRANT NO.
KB Industries, Inc. ALLOWED 20
IN SUM OF $
Bryan Dairy East, 7300 Bryan Dairy Rd., Ste. 4
Largo, FL 33777
$3,610.98
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
32554 I 12805 I 43-509.001 $3,610.98 1 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
A � l
/1, Th sday�J ,� 5
St��G7oixf'�issI&L '1//
He F
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund