HomeMy WebLinkAbout330550 10/02/18 `% ��p\'' CITY OF CARMEL, INDIANA VENDOR: 372823
;1.
.;, ONE CIVIC SQUARE ADAM NELSON CHECK AMOUNT: $*******225.00*
M Baa; CARMEL, INDIANA 46032 12891 CHARING CROSS RD CHECK NUMBER: 330550
1°\�ron�. CARMEL IN 46033 CHECK DATE: 10/02/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
250 4350900 225.00 OTHER CONT SERVICES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 372823 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
ADAM NELSON IN SUM OF$ CITY OF CARMEL
12891 C HARI NG CROSS RD 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.
CARMEL, IN 46033
Payee
$225.00
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
0 43-509.00 $225.00 1 hereby certify that the attached invoice(s),or 9/24/18 0 Rain Barrel Cost Share $225.00
2200 250 2200 250
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, September 26,2018
Jeremy Kashman
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
of C�ar
CITY OF CARMEL RESIDENTIAL r
RAIN BARREL COST SNARE APPLICATION! �
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Carmel residential property owners are eligible to receive$50 cost share per rain barrel installed or$75
cost share per barrel installed in a targeted watershed. Cost share not to exceed$375.
APPLICANT NAME: APPLICANT PHONE NUMBER:
' a,\ 1\;Z!r'%:� 31 } - t - X75
APPLICANT EMAIL ADDRESS: APPLICANT MAILING ADDRESS:
G�G�Cirw y,�i: rV d°.2 a U A. I'r �C Y � �� `tu-
PROPERTY ADDRESS:
J2?% cva'r,-� R-A- `11cc;55
PROPERTY UTILITY ACCOUNT NUMBER: NUMBER OF RAIN BARRELS FOR COST SHARE:
0O� 11` Zv'o�,) 3
RIGHT OF ENTRY
Upon approval of this application,the applicant agrees to give the City of Carmel and authorized representatives
the right to enter the premises without hindrances,and inspect any practice being installed,or that has been
installed,to receive a storm water, '
cost share.Denial of this right will result in the denial of the cost share
application. Applicant's Initials:tt11
Applicant Signature: Date: q
Required attachments for the Residential Cost Share:
Photo of Each Installed Rain Barrel(Show connection to downspout in photos)
-7Receipts
/W-9 Form
Submit application and attachments to:
By Mail:
City of Carmel
By Email: Engineering Department
stormwater@carmel.in.gov Attn: Department of Storm Water Management
1 Civic Square
Carmel,IN 46032
1
1 Of
CITY OF CARMEL.RESIDENTIAL.
RAIN BARREL COST SHARE APPLICATION
For Department of Storm Water Management Use
DATE RECEIVED: RECEIVED BY:
L// I k'-- — �� r,.e,,,S
Tar et Area: APPROVED
7COOL CREEK WATERSHED COST-SHARE AMOUNT
_CARMEL CREEK WATERSHED
_
DENIED(Reason)
STAFF SIGNATURE: DATE:
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Adam Nelson
3
5/4/2018 Order Confirmation
Soil & I,Vute 1717 Pleasant St.Suite 100 (//fac
Noblesville,IN 46060
317.773.2181
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Order Confirmation Print Receipt
Thanks for placing your order,you should receive a confirmation email shortly.
Order Date May 4th 2018,12:25:41 pm
Order Number 891544838
PERSONAL INFORMATION ORDER SUMMARY
Adam Nelson $75 Rain Barrel(55 gallon)-pick up $225.00
12891 Charing Cross Road only
Carmel,IN,46033 Qty:3
US
Color.Grey
adamkermelson@gmail.com
3175077457
BILLING INFO Subtotal $225.00
Shipping —
Adam Nelson Taxes $15.75
12891 Charing Cross Road
Carmel,IN,46033
US Order Total $240.75
3175077457
PAYMENT METHOD
Visa ending in 0461 (Exp.4/2021)
Your SWCD Contact Us Celebrating 50 years of conservation in 2018
About sail.water@hamiltancounty.in.gov 1968-2018
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