260111 06/28/16 CITY OF CARMEL, INDIANA VENDOR: 358786
98`""'1,440.00`ONE CIVIC SQUARE BOTTAMILLER LLC CHECKAMOUNT:CARMEL, INDIANA 46032 9800 N GRAY ROAD CHECK NUMBER: 260111 INDIANAPOLIS IN 46280 CHECK DATE: 06/28/16 ,
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4239034 7698 1,440.00 LANDSCAPING SUPPLIES
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201(Rev.1995)
BOTTAMILLER LLC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
9800 N GRAY ROAD IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
INDIANAPOLIS, IN 46280 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$1,440.00 Payee
Purchase Order#
ON ACCOUNT OF APPROPRIATION FOR
Street Department Terms
Date Due
PO# ACCT# DATE INVOICE# DESCRIPTION
DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
7698 42-390.34 $1,440.00 1 hereby certify that the attached invoice(s),or 6/10/16 7698 $1,440.00
2201 201 2201 201
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
&,,Tduesd# June 1 01
Street Commissioner
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
20
Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Bottamiller LLC INVOICE
9800 N. Gray Road
Indianapolis, IN 46280 DATE INVOICE#
317-844-8800 6/10/16 7698
317-844-8834 Fax
BILL TO DELIVERED
CITY OF CARMEL STREET DEPARTMENT PICKED UP PULV. TOPSOIL
3400 WEST 131ST STREET AT OUR PLANT
CARMEL, IN 46074 TICKET# 322919
P.O. NO. TERMS DUE DATE SHIP DATE SHIP VIA ORDERED BY
NET 30 DAYS 7/10/16 6/9116 THEIR TR... RON/ DRIVERS
QTY ITEM DESCRIPTION RATE AMOUNT
12 PTS PULVERIZED TOPSOIL-TRUCK#209 30.00 360.00
12 PTS PULVERIZED TOPSOIL -TRUCK#209 30.00 360.60
12 PTS PULVERIZED TOPSOIL -TRUCK#209 30.00 360.00
12 PTS PULVERIZED TOPSOIL -TRUCK#206 30.00 360.00
J
Total $1,440.00
*Unpaid balance subject to a late charge of 1 1/2% per month
on the outstanding balance.
CUSTOMER'S ORDER NO. DATE
NAME
ADDRESS
CITY,STATE,ZIP
SOLD BY CASH C.0,D. CHARGE ON.ACCT.MDSE.RET-D.PND-OUT
9'
QUAN. DESCRIPTION AMOUNT
2 -4 fir',-,{ ) f '' • `:r 4 �!,
r
70
12
' RECEIVED BY
'-T-46240/46250 KEEP.THIS SLIP FOR REFERENCE