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Home My WebLink About301681 08/08/16 OL-' CITY'OF CARMEL, INDIANA VENDOR: 358385 ONE CIVIC SQUARE GENERAL SHALE&BRICK CHECK AMOUNT: $*******144.00* CARMEL, INDIANA 46032 PO BOX 5825 CHECK NUMBER: 301681 CAROL STREAM IL 60197-5825 CHECK DATE: 08/08/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION -2201 4236200 182502957 144.00 CEMENT VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) ALLOWED 20 ACCOUNTS PAYABLE VOUCHER GENERAL SHALE & BRICK PO BOX 5825 IN SUM OF$ CITY OF CARMEL An invoice or bill to be properly itemized must show:kind of service,where performed,dates service CAROL STREAM, I L 60197-5825 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. $144.00 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 182502957 42-362.00 $144.00 1 hereby certify that the attached invoice(s),or 7/26/16 182502957 $144.00 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 Tuesday,August 02,2016 Dave Huffman Director 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 0010 General Shale ............. ..... ..... .... ........... ......... .. .......... .. .......... : . . .......... .. .......... ........... : ... . .......... ... .... .... ....... ....... .......... Invoice: 182502957 Invoice Date: 07/26/2016 Bill To: 279670 Customer P0: INLET REPAIRS CITY OF CARMEL 3400 W 131ST STREET Bill of Lading: 172753348 WESTFIELD IN 46074-8267 Goods Issue Date: 07/26/2016 Order: 320676786 Sales Rep: 399 Ship=To: CITY OF CARMEL Order Loc.: Carmel 3400 W 131ST STREET CARMEL IN WESTFIELD IN 46074-8267 Phone: 317-846-2566 Mode of Shipment: Customer Pickup / 057 Material Material Description Quantity Price Value USD Batch Number and Description 6099000573 CONCRETE BRICK 360 EA 0.40 144.00 Subtotal 144.00 TAX TOTAL 144.00 LATE PAYMENT CHARGE of I-S* PRR MONTH 0010 General Shale REFERENCE CONDITIONS ON BACK Building The American d ca Dream, Bill To: 279670 CITY OF CARMEL Bill of Lading. 172753348 ^ 3400 W 131ST STREET Date: 07/26/2016 WESTFIELD IN 46074-8267 Order Loc: Carmel CARMEL IN Sales Order: 32.0676786 Customer P0: INLET REPAIRS Ship-To: Telephone: (317) 733-2001 CITY OF CARMEL 3400 W 131ST STREET Shipper: GESH WESTFIELD IN 46074-8267 IN Carmel 057 CARMEL N Mode of Shipment: Customer Pickup BRICK STCC 32 511 Directions: Material Description Order Quantity Weight Batch 6099000573 CONCRETE BRICK 360 EA 1,800.00 LB 818-18 KG TOTAL WEIGHT 1,800.00 LB 818.18 KG Drivers Name Driver License No. and State Trucking Company Dispatcher Name Phone No. DOT # Verified By ORIGINAL -� NOT NEGOTIABLE A t RETURN TO CONSIGNOR STRAIGHT BILL OF LADING - SHORT FORM RECEIVED, subject to,the'classifica.tions and tariffs in effect on the date of the issue of this Bill of Lading,the property described below, in apparent good order, except as noted (contents and condition of contents of packages unknown), marked, consigned, and. destined as indicated below, which said carrier(the word carrier being understood throughout this contract as meaning any person or corporation in posses itln of the property under the contract) agrees to carry to its usual place of delivery at said destination, if on its route, otherwise to deliv'er`to another-carrier on the route to said destination. It is mutually agreed, as to each carrier of all or any of said property over all ol-apy portion of said route to destination, and as to each party at any time interested in all or ally of said. property, that every service to be performed hereunder shall be subject to all the terms and conditiotrs of the Uniform Domestic Straight 13111 of Laditlg �l niform Freight Classifications and the Uniform Conditions of Carriage in effect on the date hereof, if this is a rail shipment., or',n the applicable motor carrier classification or tariff if this is a motor carrier shipment. Shipper hereby certifies that he is familiar with all the terms and conditions of the said bili of lading set forth in the classification or tariff which govepis thv,transportation of this shipment, and the said terms and conditions are hereby agreed to by the shipper and accepted for himself,an his assigns. AVERAGE WEIGHT AGREEMENT SHIPMENT The description and weight indicated on this hill of lading are correct, subject to verification by carrier(s)or its(their)designated argent. This is to certify that�the articles named on the reverse side are properly classified, described, packaged, marked and labeled, and are in proper condition fo,-transportation according to the applicable regulations of the Department of Transportation. SUbject to Section,17 of the Uniform Conditions of Carriage, if this shipment is to be delivered to the consignee, without recourse on the consignor, the;consignor shall sign the following statement: The carrier shall not make delivery of this shipment without payment of freight and all other lawful charges. GENERAL SHALE (Signature of Consignor) r ri r,