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CITY OF CARMEL, INDIANA VENDOR: 00352077
jg ® '• ONE CIVIC SQUARE FLUID WASTE SERVICES INC CHECK AMOUNT: $*******625.00*
CARMEL, INDIANA 46032 PO BOX 264 CHECK NUMBER: 328670
NOBLESVILLE IN 46061 CHECK DATE: 08/09/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 W023604 625.00 OTHER EXPENSES
VOUCHER NO. 186112 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
Vendor # 352077 IN SUM OF$ 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
625.00 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-23604 01-7360-02 $625.00 and received except 7/25/2018 WO-23604 $625.00
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
6/27/2018 WO-23604
Bill To
City of Carmel Utilities Customer P.O./Job# F.T.#
9609 Hazeldell Parkway
Indianapolis,IN 46280 11989
US
Project Terms
14387 Jeffrey Court Net 30
Description Qty Rate Amount
Date:Wednesday 6/27/18 1 0.00 0.00
Contact:Larry 317-965-0658
Address: 14387 Jeffrey Court
Crew:EM/AD
Equipment:T-28
Notes:
Lateral launch to locate cause of blockage as directed.
Televising with Lateral Launch System 2.5 250.00 625.00
Thank you for your business-we appreciate it very much!Please reference Invoice#on remittance.
Total $625.00
IDEM PERMIT NO.058 Payments/Credits $0.00
Balance Due $625.00