252424 1 2/08/1 5 *. CITY OF CARMEL, INDIANA VENDOR: 366767
ONE CIVIC SQUARE VAN AUSDALL & FARRAR CHECK AMOUNT: $ 130.37
,• �� CARMEL, INDIANA 46032 PO BOX 713683 CHECK NUMBER: 252424
CINCINNATI OH 45271-3683 CHECK DATE: 12/08/15
RON
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 143870 130.37 OTHER EXPENSES
Van AUSdali MAIL REMITTANCE TO: CONTRACT INVOICE
& Farrar. VAN AUSDALL AND FARRAR,INC.
OFfU TECHNOLOGY-'"` PO BOX 713683,Cincinnati,OH 45271-3683 Invoice Number: 143870
50110"$ Phone(317)634-2913 Fax(317)638-1843
sa MA
Email invoice questions to:
Invoice Date: 11/30/2015
billing@vanausdall.com
Bill To: CITY OF CARMEL WATER PLANT 1 Customer: CITY OF CARMEL WATER PLANT 1
KEN RHODES 4915 E 106th STREET
4915 E 106th STREET CARMEL,IN 46032
CARMEL,IN 46032
Pa meet Tums t' '•:due`Date�; -• Invoice Total n
. - y z�i. ,'�,; 3 Balance Due
511614 NET10 12/10/2015 $130.37 $130.37
?Contract Number.x.:, „; Contact,,;; s„ ;_ ;;, Contract Amount" P.O::NumbeF'>`;,,� Start Date_; Y ,Exp:
A,.
16876-03 317-571-4141 $130.37 08/27/2015 08/26/2016
. Remaiics
GIVE INVOICES TO WANDA
Summary:
Contract base rate charge for this billing period $0.00.
Contract overage charge for the 08/27/2015 to 11/26/2015 overage period $130.37"
*Sum of equipment base charges **See overage details below $130.37
Detail:
Equipment,included under this contract
Number Serial Number Base Charge Location
72261 V9735500993 $0.00 CITY OF CARMEL WATER PLANT 1 4915 E 106th STREET
RICOH AFICIO MPC2051 CARMEL,IN 46032
Meter Type Meter Group Begin Meter End Meter Credits Total Covered Billable Rate Overage
B\W BW-16876-100 22,677 25,951 3,274 0 3,274 $0.005720 $18.73
Color CLR-16876-100 7,603 9,774 2,171 0 2,171 $0.051425 $111.64
$130.37
Customer Number:511614 Invoice Number:143870 Invoice SubTotal $130.37
Please Include Invoice Number on Remittance Tax: $0.00
Invoice Total $130.37
Thank you for your business! Balance Due: $130.37
Page I of 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
317000
VAN AUSDALL & FARRAR INC Purchase Order No.
PO BOX 713683 Terms
CINCINNATI, OH 45271-3683 Due Date 12/2/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/2/2015 143870 $130.37
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 # 153725 WARRANT # ALLOWED
317000 IN SUM OF $
VAN AUSDALL & FARRAR INC
PO BOX 713683
CINCINNATI, OH 45271-3683
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
143870 01-6360-03 $130.37
Voucher Total $130.37
Cost distribution ledger classification if
claim paid under vehicle highway fund