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HomeMy WebLinkAbout330643 10/02/18 �. � CITY OF CARMEL, INDIANA VENDOR: 372819 ® ONE CIVIC SQUARE THOMAS O'CONNOR BUSBY CHECK AMOUNT: $********75.00* 9 ,,�? CARMEL, INDIANA 46032 13672 SMOKEY RIDGE DR CHECK NUMBER: 330643 .y!TON�, CARMEL IN 46033 CHECK DATE: 10/02/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 250 4350900 75.00 OTHER CONT SERVICES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 372819 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER THOMAS O'CONNOR BUSBY IN SUM OF$ CITY OF CARMEL 13672 SMOKEY RIDGE DR 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 $75.00 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR 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 $75.00 1 hereby certify that the attached invoice(s),or 9/24/18 0 Rain Barrel Cost Share $75.00 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 20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer (of ce s9` ro ®s CITY OF CARMEL RESIDENTIAL RAIN BARREL COST SHARE APPLICATION q'�'°�'° 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:/ t APPLICANT PHONE NUMBER: l APPLICANT EMAIL ADDRESS: APPLICANT MAILING ADDRESS: PROPERTY ADDRESS: PROPERTY UTILITY ACCOUNT NUMBER: NUMBER OF RAIN BARRELS FOR COST SHARE: 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 Applicant S' e: Date: l Required attachments for the Residential Cost Share: Photo of Each Installed Rain Barrel(Show connection to downspout in photos) Receipts ,,,"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 e� ro _L_ v CITY OF CARMEL RESIDENTIAL ®� RAIN BARREL COST SHARE APPLICATION For Department of Storm!Nater Management Use DATE RECEIVED: RECEIVED BY: Target Area: 'APPROVED %r COOL CREEK WATERSHED COST-SHARE AMOUNT ,.fir _CARMEL CREEK WATERSHED _DENIED(Reason) STAFF SIGNATURE: DATE: 2 Tom Busby From: Tom Busby <tbusby76@yahoo.com> Sent: Monday,August 20, 2018 9:05 AM To: Tom Busby Subject: Fw: Receipt from Hamilton County Soil and Water Conservation District Sent from Yahoo Mail for iPhone On Saturday, August 18, 2018, 11:03 AIVI, Harnilton County Soil and Water Conservation District via Square <receiptsccbrnessaging.sgi_iarei.il.,.a.)rri=> vvrote: Squar;: automatically sends receipts to the email address you used at any Square seller. Learn more X Hamilton County Soil and Water Conservation How was yourexperience? 13 X 1 A2 ^ 1 J - 05 Custom Amount $115.00 Purchase Subtotal $115.00 Sales Tax (7%) $8.05 Total $123.05 VIVL�t t 1 JOHNSON CT ' PI CASAhj 1 f'LEASANI S1 :r. j �•, LU IY. Hamilton County Soil and Water Conservation District 1717 Pleasant St., 100 Noblesville, IN 46060 317-773-2181 2 Visa '1473 (Swipe) Aug 18 VV%'A 2018 at THOMAS BUSBY 11:02 AM itaTnt Auth code: 06993D 2018 Square, Inc. '1455 Market Street, Suite 600 San Francisco, CA 94,103 © Mapbox©OpenStreetMap Improve this map Square Privacy Policy • Not your receipt? Manage preferences for digital receipts �, 3 3 � 1 t• . i 1' 4 .. Ar •4L II Z t.• 1 1�1 �` �u}*•f. VIA \ � � tit,..,. - 4� Jp�► �1 4; iti ��' . { f 1"'' .ay.��, a_.. -.F y-' -.v Rr • f r- { I, 40 x� ,r Vit{ ' + 1 n '' k ` d •t F ,.t5 ii ` 1 tTb ti? 44.54{ ` • , Y � ,#{ ,k ' -1 1 / 1 t 1.. f,+I 1 I ' N. ,,'E�i1i '• �1 /14, f4.1,{' k{rlf��� 'lr��t, � ��r �� '(� .4 •� y'r,1.J',l``7�f ittL,{' t .h � +' V�rr1 � .F J�' ��r �'` ri` 1 ��t �!� '{s � �`. i l'.�� fry' ,":`!L•,c1 cVn'�it',-.in•.Ln' c +•.'• ��i:� x ,.Jtkd M 1 1�'c..trLL�• t'