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Home My WebLink About306296 Q CITY OF CARMEL, INDIANA VENDOR: 148000 S`" 36,426.26 ONE CIVIC SQUARE INDIANA DEPT OF TRANSPORTATION CHECK AMOUNT: `CARMEL, INDIANA 46032 100 N SENATE AVE,RM IGC-N 725 CHECK NUMBER: 306296 INDIANAPOLIS IN 46204-2216 CHECK DATE: 12/16/16 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 203 R4462200 33409 000038487 33,581.51 SIDEWALK IMPROVEMENTS 202 R4350900 33407 000038490 2,844.75 OTHER CONT SERVICES 0 m m O m 3 \ IN 4 j / \ / » > > 2 2 r r o m \- T T > X gg , a ? k k 2 o £ - o < 2 O O m \ \ k ® r e » m m O / Z ; ) 8 > ( i / k a § CD4 \ $ - S 2 / 5' q B \ % & o T \ ^~ \ ƒ \ 2 � ® a 2 z 7 2 / r > -n 0 O | CD \ z a = ® % ! 06 / \ / / k� \ i \ \ & ® 0 m = g m 0 2 ; -nc . /; g ,7 e c / m - CD CL _ ± - ) $ \ 2CD 7 CD/ CO, } 3 ( _ W C _ / 0 _\ 2 k 2 { - k ƒ § % / e | , / k/ G e c = , \ " $ m > CL i/ 8 / 8 i / n CT - - mn # % CD CD , /f = \ \ R � 8 -n j D \ a \ � § t m z g k ƒ 8 2 8 G 2 m ƒ - C o % /}_ § # D / 2 @ Q ° --q ) (0 2� % 3 & al\ 7 7 { % \/ 4 /j \ D \ \ ° _ c) D f §k 2\ ( m z}_ 2 / « � \ ®* » 2 / $ M / /\ \> 0. c H 2 M < 0 2 2, 0 c CD _ # CD + ( D 3 \ @ � » > \ # / CD CD C. 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F CL \ /r \ \< § E CD cn 0 ® \ T-d. �4rj} 20Z -- R43s0100 INDIANA DEPARTMENT OF TRANSPORTATION 4 Driving Indiana's Economic Growth INVOICE 100 North Senate Avenue Michael R.Pence,Governor Room IGC-N 749 Brandye Hendrickson,Commissioner a:fi Indianapolis, Indiana 46204-2216 Customer No: CST000001811 Bill To: Invoice: 000038490 Invoice Date: 11/30/2016 City of Carmel Invoice Type: LPA ATTN: Jeremy Kashman One Civic Square Carmel IN 46032 AMOUNT DUE: $2,844.75 *** Payment is Due Upon Receipt of Invoice*** Line Description Quantity Unit Amt Net Amount 1 Contract#R-35550 1.00 2,844.75 2,844.75 Project#1297165;Change Order 4.(See Attached) Subtotal: 2,844.75 AMOUNT DUE: $2,844.75 Payment Options See Reverse Side For billing questions, please call: 317-232-5363 Invoice: 000038490 • Online website: https://secure.in.gov/apps/dot/accountsreceivables/ • To create an account, use Customer#: CST000001811 • To make a credit card payment by telephone, call either:317-232-5364 or 317-232-5388 • OR RETURN THIS PORTION WITH YOUR PAYMENT Department of Transportation Invoice: 000038490 Attention:Agent Cashier N749 IGCN Amount Paid:$ 21 S'-4 H. 1 5 100 N. Senate Ave. Indianapolis, IN 46204 ❑ Visa ❑ Mastercard ❑ Discover Er Check/Money Order Name on Card Card Number (Name must appear as exactly as on card) CID(3 or 4 digit security code) Expiration Date Billing Address Signature Required: Date For billing questions, please call: 317-232-5363 Invoice: 000038490 �>t rde Order# Date Required Date Page rtr U �%O Order Construction 0017807999 11/17/2016 12/1412016 1 of 1 ana partment of Transportation Requisition Number:0000158261 y Approved by Encompass Leaders*Ta —2011 VendorID: 0000051089 REMIT001 Agency: 00800 Transportation Pay Terms: 35 Days in Arrears Fund/Object/Center: 6320015716201467030 Vendor 0000051089 REMIT001 2 RIETH-RILEY CONSTRUCTION COMPANY INC Ship To Dept Of Transportation Remit to RIETH-RILEY CONSTRUCTION Construction Management PO BOX 276 100 N SENATE AVE RM N925 INDIANAPOLIS IN 46206 INDIANAPOLIS IN 46204 RIETH-RILEY CONSTRUCTION COMPANY INC Bill To Transportation Vendor RIETH-RILEY CONSTRUCTION Dept Of Transportation Name PO BOX 276 Accounting Address INDIANAPOLIS IN 46206 100 N SENATE AVE RM N749 INDIANAPOLIS IN 46204 Vendor Name: Buyer Name:Tepner,Roger-800 Contact eMail: entail: RTEPNER@indot.IN.gov Phone: "' Purchase Order Instructions&Comments PO Closed R-35550 DES 1297165 800129716500LC3 Other Intersection Improvement on ST1001 Intersection of 111th ST& Pennsylvania ST Carmel IN in Hamilton County Greenfield District(FR-0024543 CN) Purchase.Order Line;Details Item No' Descn ttoii ` FOB Destination Ordered Q Recd UOM Unit Price Extended Amt 1- 1 100%LOCAL NON-PARTICIPATING. 1.0000 EA 2,844.7500 2,844.75 CHANGE ORDER 4 PLN 139$1194.75 AND PLN 141$1650.00.PE CHRIS MILLER.APPROVED BY CHAD NIERMAN. Deliveries acceptable only between 8:00 AM and 3:00 PM,Monday through Friday,excluding State Holidays. Units of Measure Handling,Totals Signatures The following UNICEFACT Unit of Measure Common Codes are used in this document: EA Each This area left blank Total PO Amt. $ 2,844.75 Issued by the Indiana Department of Transportation CONFIRMATION OF RECEIPT I certify that the items listed above were received.All commodities appeared to conform to specifications and showed no patent defects,except as otherwise noted. Signature of State Employee Receiver Date Signed(MonthlDay/Year) FUNDING ENCUMBERED BY THE AUDITOR OF STATE I .Ufy that there Is sufficient unencumbered balance In the above account to cover the amount of this order,and that funds have bean set aside for paynitint thereof. 111111Illll 1111111111 IN I1111111111111111111111111111111111111111111111111111IN IN IndiaosDepadmenfofTranspedados 00800 0017807999 o W v _ O m m n < �' N A -0 O Z Z O N O � ZO C7 m D D n -n 2 T 0 r r n m a O C C X Z m r� o Z C Z Z C) o Z o o m m LI,co r m ve N � m m to y -4 v -n w Z e w ('j Q N T 0 t o .A (D T t = h A c cDi =. O D N ,Q O N CL T�T1 3 Q O � N C) D Cl SL 3 O d oZ Z O K O o a I U3 3 w m 3 v s Z r n ? p = m cA r c m o O a a0 N O m c CD N O v T v 0 CL CD fD p y CD c s 3CL m m c0i `D ° m 3 m _3 Q (D N �p N (D O CL .n. S a (D O CD � 7 a N ID a 7• O CL N GN O 3 j w 0 a W ° o > m No CD 3 m � m C) D m o 0 O 0) m a m N CL Q a m� c c CD °: o -n < �� 0 ca paj N W A v m N c� CD O O fD n CD '� 3 " 00 N �_.m N c to a CD cn P 3N Q c)0 1 CD �' _ w O D Z O O = ID 0 o D �, o0 c� v v a y o 0 m o- CL M Z= _ -0 ci 0 r O n _ y (p 3 m cv m� Z N 3 0 C, Z m CD v y D) CCD v <� p c y o m N ,p fD d Q CD CD c p T n n _ L NO. = O (D 1 1 v N n o co 0 n 3 CD v N • , v y o c N N = O 7 Efl � CL W K N m O n N Z P.o, S1 ,9-09 Zc» — 1Z14L4(. 2200 INDIANA DEPARTMENT OF TRANSPORTATION c Driving Indiana's Economic Growth INVOICE 100 North Senate Avenue .: Michael R. Pence,Governor Room IGC-N 749 Brandye Hendrickson,Commissioner Indianapolis, Indiana 46204-2216 y Customer No: CST000001811 Bill To: Invoice: 000038487 Invoice Date: 11/30/2016 City of Carmel Invoice Type: LPA ATTN: Jeremy Kashman One Civic Square Carmel IN 46032 AMOUNT DUE: $33,581.51 *** Payment is Due Upon Receipt of Invoice*** Line Description Quanti UnitAmt NetAmount 1 Contract#R-36021 1.00 33,581.51 33,581.51 Project#1006027;Change Orders 6&10.(See Attached) Subtotal: 33,581.51 AMOUNT DUE: $33,581.51 Payment Options See Reverse Side For billing questions, please call: 317-232-5363 Invoice: 000038487 • Online website: haps://secure.in.gov/apps/dot/accountsreceivables/ • To create an account, use Customer#: CST000001811 • To make a credit card payment by telephone, call either:317-232-5364 or 317-232-5388 • OR RETURN THIS PORTION WITH YOUR PAYMENT Department of Transportation Invoice: 000038487 Attention:Agent Cashier N749 IGCN Amount Paid:$ 33, s 100 N. Senate Ave. Indianapolis, IN 48204 ❑ Visa ❑ Mastercard ❑ Discover dCheck/Money Order Name on Card Card Number (Name must appear as exactly as on card) CID(3 or 4 digit security code) Expiration Date Billing Address Signature Required: Date For billing questions, please call: 317-232-5363 Invoice: 000038487 .+.y Pe Orde Order# Date Required Date Page Indiana� §g OrJer Coiliglruction 0017802129 08/03/2016 1211412016 1 of 1 epartment of Transportation Requisition Number:0000151804 ds. ApprovedeyErconweslutlenhipTaam-2011 VendorlD: 0000267758REMIT001 Agency: 00800 Transportation Pay Terms: 35 Days in Arrears # 1 CHANGE ORDER Fund/Object/Center: 6320015716201467030 Vendor 0000267758 REMIT001 1 HIS CONSTRUCTORS, INC Ship To Dept Of Transportation Remit to 5150 E 65TH ST SUITE B Construction Management INDIANAPOLIS IN 46220 100 N SENATE AVE RM N925 INDIANAPOLIS IN 46204 HIS CONSTRUCTORS, INC Bill To Transportation Vendor 5150 E 65TH ST SUITE B Dept Of Transportation Name INDIANAPOLIS IN 46220 Accounting Address 100 N SENATE AVE RM N749 INDIANAPOLIS IN 46204 Vendor Name: Buyer Name:Tepner,Roger-800 Contact eMail: entail: RTEPNER@indot.IN.gov Phone: -Purchase Order instructions'&Comments PO 0017802129 R-36021 DES 1006027 800100602700000 Bike/Pedestrian Facilities on ST1055 W.of US 31 along 106th St.from Ditch Rd.to Illinois St in Hamilton County Greenfield District(FR-0022612 CN)(FR-0024697 CN) Purchase Order.Line;Qetads Item No .Desc tion ' "FOB Destination ' ' Ordered Recd UOM Unit Price Extended Arttt 1- 1 100%LOCAL NON-PARTICIPATING. 1.0000 EA 36,818.9300 36,818.93 CHANGE ORDERS 1&4 PLN 119 $15280.92;PLN 120$4437.90;PLN 123$13777.82;AND PLN 124 $3322.29.PE JASON UMLAUF. APPROVED BYAE CHAD NIERMAN. 2- 1 100%LOCAL NON-PARTICIPATING. 1.0000 EA 33,581.5100 33,581.51 CHANGE ORDERS 6&10 PLN 126 $4569.21 AND PLN 130$29012.30.PE JASON UMLAUF.APPROVED BY AE CHAD NIERMAN. Deliveries acceptable only between 8:00 AM and 3:00 PM,Monday through Friday,excluding State Holidays. Units of Measure.Handling,Totals Si natures . The following UN/CEFACT Unit of Measure Common Codes are used in this document: EA Each This area left blank Total PO Amt. $ 70,400.44 Issued by the Indiana Department of Transportation CONRRMATION OF RECEIPT 1 certify that the Items listed above were received.All commodities appeared to conform to specifications and showed no patent defects except as otherwise noted. Signature of State Employee Receiver Date Signed(MonthlDayftar) FUNDING ENCUMBERED BY THE AUDITOR OF STATE 1 certify that there Is sufficient unencumbered balance in the above account to cover the amount of this order,and that funds have been set aside for payment thereof. 1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111IN IndianaDWanrmmtolTransporls0on 00800 0017802129