252937 12/29/15 CITY OF CARMEL, INDIANA VENDOR: 366093
ONE CIVIC SQUARE REPUBLIC WASTE SERVICE-TRASH CO&INCCK AMOUNT: $***103,298.62*
s CARMEL, INDIANA 46032 ATTN:NANCY COLLINS CHECK NUMBER: 252937
832 LANGSDALE AVE CHECK DATE: 12/29/15
INDIANAPOLIS IN 46202-1150
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 12/1-12-14 103,298.62 TRASH
Republic Services
832 Langsdale Ave
Indianapolis, IN 46202-1150
ATTN: Nancy Collins
Account# 3-0761-9761020
$$$$ Collected By Carmel Utilities
Dec 1 to Dec 14 $104,907.87 2015 Rate
Less Administrative Fee 2015 $ (2,729.25)
10,917 Payments
Cart Deliveries $ 1,120.00
Payment to Republic $103,298.62
Prescribed by State Board of Accounts
Form No.301-S(Rev.1997) ACCOUNTS PAYABLE VOUCHER
TO
ADDRESS
Invoice Date Invoice Number Item Amount
I hereby certify that the attached invoice(s), or 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
Mo. Day Yr. Signature Title
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.
Mo. Day Yr. Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WASTEWATER UTILITY ACCT.
CARMEL, INDIANA
12Cnur��t� Ste.,isJavor/Of ?co(oOgS
(_/j 1-4 VSQILL / UC, /
t/kj/jP2�� -pty qLd0.1 1 f N—b 1A./ 6Ac—V C ori i
Total Amount of Voucher $
Deductions
( O'j
Amount of Warrant $ (03,)5" b
Month of 1�_L D I
Acct.
VOUCHER RECORD No.
Collection System
Pumping
Treatment&Disposal
Customer Accounts
Administrative&General
Reclaimed Water Treatment
Reclaimed Water Distribution
Total
Allowed
Board Members
Filed
BOYCE FORMS•SYSTEMS 1-800-382-8702 325