304536 10/31/16 �'.4,q+, CITY OF CARMEL, INDIANA VENDOR: 353580
4/
t=1 ONE CIVIC SQUARE CUSTOM CAST STONE INC CHECK AMOUNT: $*******270.00*
�_�: CARMEL, INDIANA 46032 734 E 169TH ST CHECK NUMBER: 304536
''��ruN�o, WESTFIELD IN 46074 CHECK DATE: 10/31/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4236200 75771 270.00 CEMENT
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
CUSTOM CAST STONE INC ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
734 E 169TH ST IN SUM OF$ CITY OF CARMEL
An invoice or bill to be properly itemized must show:kind of service,where performed,dates service
WESTFI ELD, IN 46074 rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc.
$270.00 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
75771 42-362.00 $270.00 1 hereby certify that the attached invoice(s),or 10/19/16 75771 $270.00
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
Monday, October 24,2016
Dave Huffman
Director
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
Invoice
Eli—
� Invoice#
75771
&KC_H- ?..LC:TLIRAL • CC',.4M RCLAL RES3i9EN'TIAL
Invoice Date:
734 E. 169th St 10/19/16
Westfield, IN 46074
Page:
1
(317) 896-1700
Bill To: Carmel Street Dept. Ship To: ref; Indiana Arts
3400 W Main Street
Westfield, IN 46074
Customer ID Invoice - Date Payment Terms -.
INDIANA 10/19/16 _ i _ Due on receipt
Purchase Order No Description
Cust Pick-Up 10/13/16 I Boyd 16-1195;
• _ -
Description -
SHIP TICKET 60330
2 WALLCOPING Wall Coping "A4" Pcs. 90.00 180.00
1 WALLCOPING Wall Coping "A6" Pcs. 90.00 90.00
Pallets= 1
Weight= 385 LBS.
J#16-1195
1.5% interest per month will be Subtotal 270.00
added to all invoices not paid Freight 0.00
within 30 days. Sales Tax 0.00
Payment/Credit 0.00
-` Deposit 0.00
THANK YOU FOR YOUR ORDER Total 270.00
Shipping Ticket
jT
Shipping ing No.: 60330
[C U ;S T 0 k C A S T . S T 0 Date: 10/13/16
ARCHITECTURAL • CONts.t RCIAL RESIDENTIAL page. 1
Voice: (317)896-1700 Fax: (317)896-1701
Sold To: Ship To:
Carmel Street Dept.
Carmel, IN 46032
Customer ID: ed Order Number Sales Representative
INDIANA JKG
Description Shipping Method Payment Terms
16-1195;lndiana Arts Cust Pick-Up Due on receipt
7Quantity I Item Number Description
2 WALLCOPING Wall Coping "A4" Pcs.
1 WALLCOPING Wall Coping "AT Pcs.
Pallets = 1
Weight = 385 LBS.
J#16-1195
Custom Cast Stone product(s)must be inspected immediately upon receiving the product. Any claim for damages must be noted on the freight
bill and or the packing slip and a claim filed with the freight company. Any product defects must be reported in writing to Custom Cast Stone
within ten(10)days from receipt of the order. Custom Cast Stone will replace or repair any products damaged due to defective manufacturing by
Custom Cast Stone.If defective material is not reported to Custom Cast Stone within the specified timeframe as shown above any replacement or
repair will become the Buyer's responsibility. Custom Cast Stone accepts no responsibility for the installation or liability with regard to the
contractors or pieces damaged during the installs 'on process. /)
Mvv -�, –?—Y,/,
Accepted By Print Name Date