251510 11/18/15 u Coq
``� CITY OF CARMEL, INDIANA VENDOR: 355029
® zl ONE CIVIC SQUARE DIRTWORKS LLC CHECK AMOUNT: $*******460.00*
:. a CARMEL, INDIANA 46032 5925 E 722ND STREET CHECK NUMBER: 251510
�y_raN�` CARMEL IN 46033 CHECK DATE: 11/18/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 14999 460.00 OTHER EXPENSES
Dirtw®rks, LLC
5925 East 122nd Street Invo`Ce
Carmel, IN 46033 ,-
Phone # (317)428-8210 Fax # (317)846-0338 >
10/31/2015 14999
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City of Carmel Utilities
3450 West 131st Street
Westfield, IN.46074
D:ue�Date
12/1/2015
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10/2/2015 Ticket#167819, Shop by#72 4 20.00 80.00
Same by#70 4 20.00 80.00
10/6/2015 Ticket#220586,Lakeshore by#70 1 20.00 20.00
10/7/2015 Ticket#609093, Shop by#145 1 20.00 20.00
Same by#70 2 20.00 40.00
10/8/2015 Ticket 9609163,Shop by 470 1 20.00 20.00
Same by#72 1 20.00 20.00
10/9/2015 Ticket#609037,3325 Thistlewood Ct by#72 1 20.00 20.00
Same by#70 2 20.00 40.00
10/13/2015 Ticket#912757, Shop by 970 1 20.00 20.00
Same by#72 1 20.00 20.00
10/23/2015 Ticket 4467822 by#72 1 20.00 20.00
Ticket#467820 by#145 1 20.00 20.00
Ticket 9467818 by#70 1 20.00 20.00
10/28/2015 Ticket#709120,Cannel Station by#70 1 20.00 20.00
-If Your Account is 60 Days Past Due-----Your Account Will be Closed until
Payment Is Received! TORI $460.00
R a'a n c u e $460.00
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 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 11/5/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/5/2015 14999 $460.00
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
i/h Z-//s &,-
Date Officer
VOUCHER # 153517 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
14999 01-6360-06 $460.00
Voucher Total $460.00
Cost distribution ledger classification if
claim paid under vehicle highway fund