249232 09/09/15 Cqq
CITY OF CARMEL, INDIANA VENDOR: 355029
ONE CIVIC SQUARE DIRTWORKS LLC CHECK AMOUNT: $*******580.00*
CARMEL, INDIANA 46032 5925 E 122ND STREET CHECK NUMBER: 249232
CARMEL IN 46033 CHECK DATE: 09/09/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 14621 580.00 OTHER EXPENSES
0 C
5925 East 122nd Street Invoice
Carmel, IST 46033
Phone # (317)429-9210 Fax# (317)946-0339 =Date (t1VQ1Ge
8/31/2015 14621
B�I� fio
City of Carmel Utilities
3450 West 131st Street
Westfield, IN.46074
10/1/2015
Date Descstiptlon Qty Rate Amount
8/5/2015 Ticket#076801, Saddleback by#70 2 20.00 40.00
Same by#72 1 20.00 20.00
8/11/2015 Job#2677,Ticket#432605,Old Meridian&S.Main St by FWS#C23 1 50.00 50.00
8/13/2015 Ticket#307878, Shop by#205 1 30.00 30.00
Same by#70 1 20.00 20.00
Same by#145 1 20.00 20.00
Same by#72 1 20.00 20.00
8/14/2015 Ticket#307915,Lake Forest Parkway by 472 1 20.00 20.00
Same by#70 2 20.00 40.00
Ticket#307935, 131st St Carmel Water by Street#205 6 30.00 180.00
8/17/2015 Ticket#250612,Village Dr by#70 1 20.00 20.00
Same by#72 1 20.00 20.00
Ticket#371416, 1.31st&Shelborne by#05 2 30.00 60.00
8/27/2015 Ticket#505402, Shop by#145 1 20.00 20.00
Same 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! 3 n cte-, D u e TOMB $580.00
$580.00
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
3555029
DIRTWORKS LLC Purchase Order No.
5925 EAST 122ND STREET Terms
CARMEL, IN 46033 Due Date 9/3/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/3/2015 14621 $580.00
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
VOUCHER # 152979 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
14621 01-6360-06 $580.00
Voucher Total $580.00
Cost distribution ledger classification if
claim paid under vehicle highway fund