319970 12/21/17 CITY OF CARMEL, INDIANA VENDOR: 358820
ONE CIVIC SQUARE NOBLESVILLE LANDFILL CHECK AMOUNT: $********25.00*
CARMEL, INDIANA 46032 1801 S 8TH STREET CHECK NUMBER: 319970
°y �or NOBLESVILLE IN 46060 CHECK DATE: 12/21/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350100 22122 25.00 BUILDING REPAIRS & MA
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995)
Vendor# 358820 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
NOBLESVILLE LANDFILL IN SUM OF$ CITY OF CARMEL
1801 S 8TH STREET 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.
NOBLESVILLE, IN 46060
Payee
$25.00
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
22122 43-501.00 $25.00 1 hereby certify that the attached invoice(s),or 11/30/17 22122 $25.00
2201 2201 2201 2201
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
Wednesday, December 13,2017
Huffman, Dave
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
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Nob esville
andfill Inc
$ILL TO INVOICE# 22122
Carmel Street Department DATE 11/30/2017
3400 W 131 st Street DUE DATE 11/30/2017
Carmel, IN 46074 TERMS Due on receipt
DATE TICKET/TRUCK NUMBER QTY RATE AMOUNT
11/08/2017 Read KHLDeer 1 _ 25.00 25.00
116231
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------
BALANCE DUE $25M
1801 S. 8'Street • Noblesville, IN 46060
317-770-8155 • Fax 317-770-8999
NobLandfill
ville 116231
Inc
` jz
Date:
&4��1 S
PO: -
Phone:
JOB NAME:
Type of Truck
❑ Pick up/small trailer ❑ Semi-dump
❑ Single axle/large trailer ❑ 20 yd dump box
❑ Tandem axle ❑ 40 yd dump box
❑ Tri axle ❑ Others 2
CIRCL E:
D Fill Dirt Other
Top Soil, unpulverized Top Soil, pulverized
# OF LOADS IN: 2`
# OF LOADS OUT: 12
Driver's Signature
Truck# e3 ria vo-e s" - 1j e a re ?'2t.(
1801 S. 8th STREET
NOSLESVILLE, IN 46060
(317) 770-8155