250643 10/21/15 ' CITY OF CARMEL, INDIANA VENDOR: 355029
ONE CIVIC SQUARE DIRTWORKS LLC CHECK AMOUNT: $ ....*'60.00`
i4 CARMEL, INDIANA 46032 5925 E 122ND STREET CHECK NUMBER: 250643
CARMEL IN 46033 CHECK DATE: 10/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 14901 60.00 OTHER EXPENSES
Dirtworks, LLC
5925 East 122nd Street Invoice
Caravel. IN 46433
Phone # (317)428-8210 Fax # (317)846-0338 { Oester."`= -'�fIUOICe #ry
9/30/2015 14901
City of Carmel Utilities
3450 West 131 st Street
Westfield,IN.46074
TMDueDate
11/1/2015
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9/17/2015 Ticket#505422,Thistlewood Ct by#70 1 20.00 20.00
9/30/2015 Ticket#908734, 116th&College by#70 1 20.00 20.00
Same by#72 1 20.00 20.00
-If Your Account is 60 Days Past Due-----Your Account Will be Closed until
Payment Is Received! Total $60.00
Balance Douce $60.00
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 10/13/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/13/201! 14901 $60.00
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 # 153310 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
14901 01-6360-06 $60.00
i
Voucher Total $60.00
Cost distribution ledger classification if
claim paid under vehicle highway fund