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HomeMy WebLinkAbout307643 01/27/17 1+w.G��,MR < CITY OF CARMEL, INDIANA VENDOR: 148000 t ONE CIVIC SQUARE INDIANA DEPT OF TRANSPORTATION CHECK AMOUNT: $."MRt6 119.46` CARMEL, INDIANA 46032 100 N SENATE AVE,RM IGC-N 725 CHECK NUMBER: 30764396 INDIANAPOLIS IN 4204-2216 CHECK DATE: 01/27/17 M,�roH DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 202 4350900 000039185 1,648.40 OTHER CONT SERVICES 2200 4357004 000039240 200.00 EXTERNAL INSTRUCT FEE 202 4350900 000039304 4,271.06 OTHER CONT SERVICES w « / N) m O k k B q O i 2 � 2 2 D 2 0 C J © I q / ? / q / / R 6 q J / / m / O R E g w z ƒ k n 8 q m O # n a ( A # -n t / 5 > $ 2 k / § S % / q t / 5' q $ z q / / § § E n w w m 7 \ % D k ^ 2 2 29 2 < > - 9 / \ O E | \ E $ J / % i k r g § W ki $ o m / § 3 R ƒ i o 7 E 2 } CD # 2 @ f 3 } m 2 9 3 / - k - § ) @ $ / 8 ƒ 7 ¥ 3 0 7 0 0 d P, 5 � m k ® N i { � / / . ; ( i E 7 - k ƒ N » 2 3 ) 7 y K« to \ m § E e E$ 8 = ®--4 e m \ [ ; E 3 i \ ) \ # § / o -n < � 2 0 m a § § § Q £ g ƒ e 8 2 q ƒk k C o 2 / A _ D 3 Z Q § { 3 / / F)< n \ R 2 _0 \f CD / G C) 9\ - f % E ) §/ & o ; « 67 / % m &_ ¥ E CDr ® M m - 0 f n a ) 2. j E M O m 2z % cn cn / m \ C \ CD \ \ § m f � n CD � m to / - (D M \ c a - � CL _ - ] § k / z , \ \ m \ / 9 \ § \ 0 Z S ® ) _ INDIANA DEPARTMENT OF TRANSPORTATION � a Driving Indiana's Economic Growth INVOICE r 100 North Senate Avenue Eric Holcomb,Governor 4 Room IGC-N 749 Joe Mc Guinness,Commissioner t y ,t c1 Indianapolis, Indiana 462042216 Customer No: CST000031703 Bill To: Invoice: 000039240 Invoice Date: 1/17/2017 Caleb Warner Invoice Type: MSC 1 Civic Square Carmel IN 46032 AMOUNT DUE: $200.00 *** Payment is Due Upon Receipt of Invoice*** Line Description Quantity Unit Amt Net Amount 1 Training 1.00 200.00 200.00 Certified Technician Program Subtotal: 200.00 AMOUNT DUE: $200.00 Payment Options See Reverse Side For billing questions, please call: 317-232-5363 Invoice: 000039240 • Online website: https:Hsecure.in.gov/apps/dot/accountsreceivables/ • To create an account, use Customer#: CST000031703 • To make a credit card payment by telephone, call either:317-232-5364 or 317-232-5388 • OR RETURN THIS PORTION WITH YOUR PAYMENT Department of Transportation Invoice: 000039240 Attention:Agent Cashier o0 N749 IGCN Amount Paid:$ X00 100 N. Senate Ave. Indianapolis, IN 46204 ❑ Visa ❑ Mastercard ❑ Discover ❑ Check/Money Order Name on Card Card Number (Name must appear as exady 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: 000039240 < « / � q O / k k CD ? \ \ 2 2 D 2 5 0 n \ ^ \ $ \ # 2 / 0 0 > m CL \ \ ¢ / k O % S 8 9 w z ƒ k [ § 2 m m 0 _ & a � c ® - 2 0 k z / _I � k / / ) � a 0 q z = D / § § § §E q> / 8 8 © 7 ® 2 & g 2 2 2 Q w z$ / /< - o d -N\ § % ) i > 0 ( k ƒ \ 3 k k & g 75' 7 ¥ , E 2 o m \ 2 D i Q _ O C- k } \ k m m . E — 0 ) 2 % / GCD 7 2 / E Q 0 d C � k § k @ < / , g J a E C $ — k § 7 3 3 0 [ @ � - # $E ® N) - _ - ! ro � m E i 8 \ o \ -09. 0 * w w # m \ [ Cl. ; CD & > \ ) \ g § / 8 8 -nz � # 0 ca G § N § N § z g E g OCD 8 8 q \ 2 q ƒ k k C o ( E 2 m © � f 3 / %I _� / { § 0< Q \ \f f E 2 ( \ % f § , G = Q m « 0 > \ \ M \ \ ) \ § » 2 0 { nCD 5 0 a f o \ $ z ] i % a C CD m / E $ / , CD E E - CD\ ] -n k G mCL CL CL § C k ^ z CL « > } § o a CD » \ - % E CD in 0) :0. k 4 INDIANA DEPARTMENT OF TRANSPORTATION ,a a% Driving Indiana's Economic Growth INVOICE 100 North Senate Avenue q0 Room IGC-N 749 Michael R.Pence,Governor T Indianapolis, Indiana 46204-2216 Brandye Hendrickson,Commissioner Customer No: CST000001811 Bill To: Invoice: 000039185 Invoice Date: 1/12/2017 City of Carmel Invoice Type: LPA ATTN: Jeremy Kashman One Civic Square Carmel IN 46032 AMOUNT DUE: $1,648.40 *** Payment is Due Upon Receipt of Invoice**� Line Description Quantity Unit Amt Net Amount 1 Contract#R-35550 1.00 1,648.40 1,648.40 Project#1297165;Change Order 9.(See Attached) Subtotal: 1,648.40 AMOUNT DUE: $1,648.40 Payment Options See Reverse Side For billing questions, please call: 317-232-5363 Invoice: 000039185 • 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: 000039185 Attention:Agent Cashier N749 IGCN Amount Paid: $ I J V 4% . 40 100 N.Senate Ave. Indianapolis, IN 46204 ❑ Visa ❑ Mastercard ❑ Discover L°1 Check/Money Order Name on Card Card Number (Name must appear as exactly as cn card) CID(3 or 4 digit security code) Expiration Date Billing Address Signature Required: Date For billing questions, please call: 317-232-5363 Invoice: 000039185 rlrOrder Order# Date Required Date Page onstruction 0014803393 09/11/2013 02/04/2017 1 of 1 ndiana epartment of Transportation Requisition Number:0000094650 Approved by Enowepaee Laaderahiplla--2MI VendorlD: 0000051089 REMIT001 Agency: 00800 Transportation Pay Terms: 35 Days In Arrears # 2 CHANGE ORDER Fund/Object/Center: 63200!5716201467030 Vendor 0000051089 REMIT001 3 RIETH-RILEY CONSTRUCTION COMPANY INC Ship To Dept Of Transportation Remit to RIETH-RILEY CONSTRUCTION Contract Admin Division PO BOX 276 100 N SENATE AVE RM N725 INDIANAPOLIS IN 46206 INDIANAPOLIS IN 46204 RIETH-RILEY CONSTRUCTION COMPANY INC Bili To Transportation Vendor RIETH-RILEY CONSTRUCTION Dept Of Transportation Name 25200 SR 23 Accounting Address PO BOX 1775 100 N SENATE AVE RM N749 SOUTH BEND IN 46634 INDIANAPOLIS IN 46204 Vendor Name: Buyer Name:Bennett,Tammy-800 Contact entail: entail: TBENNETT@indot.IN.gov Phone: Purchase Order Instructions&Comments. . P00014803393 R-35550 DES 1297165 800129716500LC3 Other Intersection Improvement on ST1001 intersection of 111th ST 1£ Pennsylvania ST Carmel IN in Hamilton County Greenfield District(FR-0026242 CN)(FR-0027220 CN) � Purchase Order Line Details item 0" - Descri tion `4FOB Destination Q Ordered - Recd UOM UnitPnce Extended Amt'' 1- 1 10%LPA 90%FEDERAL. 1.0000 0 EA 1,457,224.0300 1,457,224.03 2- 1 90%Federal 10%Local.CHANGE 1.0000 EA 11,500.0000 11,500.00 ORDER 1.PE CHRIS MILLER.APPROVED BYAE CHAD NIERMAN. 3- 1 90%Federal 10%Local.CHANGE 1.0000 EA 16,484.0000 16,484.00 ORDER 9.PE CHRIS MILLER.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.Mandlina,`Totals Signatures The following UNICEFACT Unit of Measure = Common Codes are used in this document: EA Each This area left blank Total PO Amt. $ 1,485,208.03 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(Month/Day/Year) FUNDING ENCUMBERED BY THE AUDITOR OF STATE I certify that there is sufncient unencumbered balance in the above account to cover the amount of this order,and that funds have been set aside for payment thereof. 111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 IIII Indiana Departrnent of Transponatlon 00800 0014803393 INDIANA DEPARTMENT OF TRANSPORTATION Driving Indiana's Economic Growth INVOICE 100 North Senate Avenue O Eric Holcomb,Governor Room IGC-N 749 4r ,;�• Joe McGuinness,Commissioner O Ttt Indianapolis, Indiana 46204-2216 Customer No: CST000001811 Bill To: Invoice: 000039304 Invoice Date: 1/18/2017 City of Carmel Invoice Type: LPA ATTN: Jeremy Kashman One Civic Square Carmel IN 46032 AMOUNT DUE: $4,271.06 *** Payment is Due Upon Receipt of Invoice*** Line Description Quantity UnitAmt Net Amount 1 Contract#R-35550 1.00 4,271.06 4,271.06 Project#1297165;Change Order 6.(See Attached) Subtotal: 4,271.06 AMOUNT DUE: $4,271.06 Payment Options See Reverse Side For billing questions, please call: 317-232-5363 Invoice: 000039304 • Online website: https://secure.in.gov/apps/dot/accountsreceivables/ • To create an account, use Customer#: CST000001811 • To make a credit card payment by telephone, call either:317-232-5364 or 317-232-5388 • OR RETURN THIS PORTION WITH YOUR PAYMENT Department of Transportation Invoice: 000039304 Attention:Agent Cashier N749 IGCN Amount Paid:$ 4)7-11- 0(o 100 N.Senate Ave. Indianapolis, IN 46204 ❑ Visa ❑ Mastercard ❑ Discover O/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: 000039304 %reOrder# Date Required Date Page g Order Co Struction 0017802126 08/03/2016 09/29/2016 1 of 1 rqr anaepartment of Transportation Requisition Number:0000151801 Appmred by Encompa aLmdmhip.Taam-2011 VendorID: 0000051089 REMIT001 Agency: 00800 Transportation Pay Terms: 35 Days In Arrears Fund/Oblect/Center: 632001571620/467030 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 entail: eMail: RTEPNER@Indot.IN.gov Phone: Purchase Order Instructions&Comments PO 0017802126 R-35550 DES 1297165 800129716500LC3 Other Intersection Improvement on ST1001 Intersection of 111th ST& Pennsylvania ST Carmel IN in Hamilton County Greenfield District(FR-0022381 CN)(FR-0023650 CN) Purchase Order Line Details Item No Description FOB Destination Oty Ordered Qty Recd UOM Unit Price Extended Atnt 1- 1 100%LOCAL NON-PARTICIPATING. 1.0000 0 EA 2,260.3800 2,260.38 CHANGE ORDER 2 PLN 137.PE CHRIS MILLER.APPROVED BY AE CHAD NIERMAN. 2- 1 100%LOCAL NON-PARTICIPATING. 1.0000 EA 4,271.0600 4,271.06 CHANGE ORDER 6 PLN 143$3419.77 and PLN 147$851.29.PE CHRIS MILLER,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 Signatures The following UN/CEFACT Unit of Measure Common Codes are used in this document: EA Each This area left blank Completed / Closed Total PO Amt. $ 6,531.04 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 Slgned(Month/DayfYear) FUNDING ENCUMBERED BY THE AUDITOR OF STATE I 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 p payment thereof. 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 1"d Department of nansponzeon 00800 0017802126