HomeMy WebLinkAbout327591 07/18/18 i p{.C�q*
�! �F\, CITY OF CARMEL, INDIANA VENDOR: 00352077
® `I ONE CIVIC SQUARE FLUID WASTE SERVICES INC CHECK AMOUNT: $*******487.50*
s9� ji CARMEL, INDIANA 46032 PO BOX 264 CHECK NUMBER: 327591
.y��ioN E° NOBLESVILLE IN 46061 CHECK DATE: 07/18/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 W023614 487.50 OTHER EXPENSES
VOUCHER NO. 186013 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
Vendor # 352077 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
FLUID WASTE SERVICES,INC. CITY OF CARMEL
PO BOX 264 An invoice or bill to be properly itemized must show: kind of service,where performed,
Noblesville, IN 46061 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit, etc.
Payee
487.50 352077 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR FLUID WASTE SERVICES,INC. Terms
Carmel Wasterwater Utility PO BOX 264 Due Date
BOARD MEMBERS
I hereby certify that that attached invoice Noblesville,IN 46061
(s),
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT for which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
WO-23614 01-7360-04 $487.50 and received except 7/12/2018 WO-23614 $487.50
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. 20_
Clerk-Treasurer
Fluid Waste Services, Inc. Invoice
P.O.Box 264
Noblesville,IN 46061 Date Invoice#
317-773-7996
6/28/2018 WO-23614
Bill To
City of Carmel Utilities Customer P.O./Job# F.T.#
9609 Hazel Dell Parkway
Indianapolis,IN 46280 11963
US
Project Terms
Keystone Ave.&96th St.-L/S Bypass Net 30
Description Qty Rate Amount
Date:Thursday 6/28/18 1 0.00 0.00
Contact:Joe Faucett 317-571-2634
Additional:Larry 317-965-0658
Address:Lift Station Bypass-Keystone Ave.&96th St.
Crew:EB/DS
Equipment:P-25
Water:N/A
Disposal:Provided onsite manhole
Notes:
Pump down lift station as directed.
Liquid Vacuum Unit 2.5 195.00 487.50
Thank you for your business-we appreciate it very much!Please reference Invoice#on remittance.
Total $487.50
IDEM PERMIT NO.058 Payments/Credits $0.00
Balance Due $487.50
Service-Date: /
FWs No. 16049
..".-1,
-Order Date: f�,/, ,f�J' Fluid Waste Services Inc. k
P.O. Box 264 . Noblesville-I1oT 46061:
Order By: Phone: Phone 317.773.7996 • Fax 3:17.776.0403
www fluidwasteserviceS.COM
BILL TO: F,�r ��' ',j s - Client P.O./Job#
Job Location/Name i 7T",?? i
Directions
Contact Name Job Contact
Office Fax Office Cell
Job Description by Client- b- 'T'
Job Description by FWS Crew- =
Job Complete Yes/No - List Work Required- s
~❑ 7et%Vac ❑ Jet ❑ JetnVlmi ❑ Vac Truck ❑ Hydro E K ❑ Liquid Vac ..❑ Tanker O Video ❑ Insptectson
FWS Crew#1 - Eqpt.' Reg/OT--Qty. Rate
:
Travel 'L/ cl Job In 5'10`'' Out f- �` Travel
FWS Crew#2 Eqpt. Reg/OT-Qty. Rate
Travel Job In OutTravel =
❑ Supervisof '
❑ Labor ❑ Support Vehicle ❑ D'i7 Pxime Units ❑ Water Truck ❑yxvc by Othexs y
Eqpt. Reg/OT Qty Rate
Travel Job In Out Travel
fl Permits ❑ Testmg'Fee ❑ ;Pexdtum ❑ CSE ❑ Protective Gear.- �l Materials;`
.... w
FWS Other Charges Qty. Total
Vacuum Tube Solid Rate Flex Rate o#al
Other Materials/Tools/SuppliesQty. Rate hgtal
Disposal Site Type Gallons Rate
Water Source Qty RateTotal --
Disposal Receipt# Total Charges
Terms: All invoice charges are due 30 days from completion date. Finances charges will be applied on overdue
invoices at a rate of 10%.We accept MasterCard and Visa credit cards for payments. Pleasw,.ireferenc6 Or m=
voice number on all checks.
I Acknowledge the Satisfactory Completion of the Above Work.
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