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251053 11/04/15 CITY OF CARMEL, INDIANA VENDOR: 361229 ® ONE CIVIC SQUARE DRAINAGE SOLUTIONS, INC CHECK AMOUNT: $*1*113,565.85' CARMEL, INDIANA 46032 771 INTERNATIONAL DRIVE CHECK NUMBER: 251053 FRANKLIN IN 46131 CHECK DATE: 11/04/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 250 4350900 0038389 3,565.85 OTHER CONT SERVICES 250— L4'_;So 9 0 0 — Mail Payments To: 771 International Dr Invoice DRAINAGE Franklin, IN 46131 SOLUTIONS,INC (317) 346-4110 Invoice Number: 0038389-IN (317) 346-4109, Fax Invoice Date: 9/10/2015 www.drainagesolutionsinc.com Due Date 10/10/2015 Customer Number: C112000 Sold To: Ship To: Carmel Street Dept. Carmel Street Dept. 3400 W. 131st. St. 3400W. 131st. St. Carmel, IN 46074 Carmel, IN 46074 P E Amy Lunn Customer P.O. Ship VIA F.O.B. Terms Tracking Number Net 30 Days Item Code Unit Ordered Shipped Back Ordered Price Amount 30601 EA 1.00 1.00 0.00 17.85 17.85 Pipe Lube-Gallon Whse: 001 36DWPIPE FEET 100.00 100.00 0.00 33.73 3,373.00 36"HDPE Doublewall Pipe Solid w/F477 Gasket x 20'(BE) Whse: 001 /NONINVENTORY EACH 1.00 1.00 0.00 175.00 175.00 Mar Mac Coupling contact Eic 317-752-2706 JT All returns must be clean, merchantable and immediately ready for resale. All Net Invoice: 3,565.85 approved returns are subject to a 25%restocking charge to be deducted from the Less Discount: 0.00 original purchase price. All returns that require pick-up by Drainage Solutions, Inc. Freight: 0.00 (DSD will be assessed a freight charge to be determined by DSI. Return freight Sales Tax: 0.00 Invoice Total: 3,565.85 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 Drainage Solutions, Inc Purchase Order No. 771 International Drive Terms Franklin, IN 46131 Date Due Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s) Amount 9/10/2015 0038389-IN 36" HDPE Doublewall Pipe and installation $ 3,565.85 Total $ 3,565.85 1 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 I VOUCHER NO WARRANT NO. Drainage Solutions, Inc ALLOWED 20 771 International Drive IN SUM OF $ Franklin, IN 46131 $ 3,565.85 ON ACCOUNT OF APPROPRIATION FOR Board Members PO#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT# I hereby certify that the attached invoice(s), or 0 0038389-IN 250-4350900 $ 3,565.85 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 /—� 11/2/2015 Signature City Engineer Cost Distribution ledger classification if Title claim paid motor vehicle highway fund