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HomeMy WebLinkAbout308089 02/13/17 �+ut-C,pyF CITY OF CARMEL, INDIANA VENDOR: 371498 ® ONE CIVIC SQUARE DEPARTMENT OF TRANSPORTATION CHECK AMOUNT: S"'""1,679.69` CARMEL, INDIANA 46032 ATTN:AGENT CASHIER N749 IGCN CHECK NUMBER: 308089 100 N.SENATE AVENUE CHECK DATE: 02/13/17 INDIANAPOLIS IN 46204 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 203 4462200 000038077 1,679.69 SIDEWALK IMPROVEMENTS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 371498 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER DEPARTMENT OF TRANSPORTATION IN SUM OF$ CITY OF CARMEL ATTN: AGENT CASHIER N749 IGCN An invoice or bill to be properly itemized must show:kind of service,where performed,dates service rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. INDIANAPOLIS, IN 46204 Payee $1,679.69 ON ACCOUNT OF APPROPRIATION FOR . Purchase Order# Engineering 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 000038077 44-622.00 $1,679.69 Ihereby certify that the attached invoice(s),or 10/24/16 000038077 Final amount due for bike/ped bridge over $1,679.69 2200 203 Prior Year 2200 203 Carmel Drive for Monon Trail 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, February 07,2017 Kashman,Jeremy 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 INDIANA DEPARTMENT OF TRANSPORTATION s : . Driving Indiana's Economic Growth INVOICE 100 North Senate Avenue Room IGC-N 749 Michael R.Pence,Governor �. Brandye Hendrickson,Commissioner Indianapolis, Indiana 46204-2216 y Customer No: CST000001811 Bill To: Invoice: 000038077 Invoice Date: 10/24/2016 City of Carmel Invoice Type: LPA ATTN: Jeremy Kashman One Civic Square Carmel IN 46032 AMOUNT DUE: $1,679.69 *** Payment is Due Upon Receipt of Invoice*** Line Description Quantity Unit Amt Net Amount 1 Contract#:&27185 1.00 1,679.69 1,679.69 Project#:9929036;DES:0300059. Final amount due to INDOT to close project. _ Subtotal: 1,679.69 AMOUNT DUE: $1,679.69 Payment Options See Reverse Side oevw bike 1p e d bri d 9e ow-eft Co-%.r -%el D-'sva Mon ort Tra i t 203 — For billing questions, please call: 317-232-5363 Invoice: 000038077 • Online website: https://secure.in.gov/apps/dot/accountsreceivables/ • To create an account, use Customer#: CST000001811 • To make a credit card payment by telephone, call either:317-232-5364 or 317-232-5388 • OR RETURN THIS PORTION WITH YOUR PAYMENT Department of Transportation Invoice: 000038077 Attention:Agent Cashier N749 IGCN Amount Paid:$ 1 t loAct. bh 100 N.Senate Ave. Indianapolis, IN 46204 ❑ Visa ❑ Mastercard ❑ Discover ❑ 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: 397-232-5363 Invoice: 000038077