248285 08/12/15 CITY OF CARMEL,
, INDIANA VENDOR: 00353052
ONE CIVIC SQUARE CONCRETE SURGEONS INC CHECKAMOUNT: S"•"""'375.00'CARMEL, INDIANA 46032 4761 INDUSTRIAL PARKWAY CHECK NUMBER: 248285
INDIANAPOLIS IN 46226 CHECK DATE: 08/12/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350900 34450 375.00 OTHER CONT SERVICES
4761 Industrial Parkway Invoice
Indianapolis, IN 46226
MOM317-897-0600
fax:317-897-0606 DATE INVOICE#
www.concretesurgeons.com
7/21/2015 34450
BILL TO
MR.JIM HOBBS
CARMEL UTILITIES
9609 HAZEL DELL PARKWAY
INDIANAPOLIS, IN 46280
P.O. No. TERMS PROJECT
Net 30
—QUANTITY---Y~- 6i -- --=DESCRIPTION -- ----- - RATE —� - _ AMOUNT--
JOB LOCATION: STREET DEPT-3RD AVE SW-CARMEL,
IN
HAND/RING/CHAIN SAW THRU 6"CONCRETE CURB FOR 375.00 375.00
HANDI-CAP RAMP
I
you for your siness
Total $375.00
ganko
e Cncrete Surgeons assume no
bliltywhat so ever for layout of
wall/floor openings, holes or lines, or
for cutting any buried electrical,gas or
water-sewere lines.
r
VOUCHER NO. WARRANT NO.
ALLOWED 20
Concrete Surgeons
IN SUM OF$
4761 Industrial Parkway
Indianapolis
$375.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. I ACCT#/TITLE AMOUNT Board Members
2201 I 34450 I 43-509.001 $375.00 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
Thr day t 015
t�fThi�r�r �
Title
i
Cost distribution ledger classification if
claim paid motor 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 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))
07/21/15 34450 $375.00
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
, 20
Clerk-Treasurer