HomeMy WebLinkAbout330635 10/02/18 VOUCHER NO. WARRANT NO. Prescribed by State Board or Accounts City Form No.201 (Rev.1995)
Vendor# 372818 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
RUTH E BROWN IN SUM OF$ CITY OF CARMEL
121 3RD ST NW 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 46032
Payee
$75.00
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 $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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer
Cd C06-
CITY OF CARMEL RESWENTBA►L
RAIN BARREL COST SNARE A PPLOCA'I.00N
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:
APPLICANT EMAIL ADDRESS: APPLICANT MAILING ADDRESS:
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PROPERTY ADDRESS:
1 z 3,41
PROPERTY UTILITY ACCOUNT NUMBER: NUMBER OF RAIN BARB RELS FOR COST SHARE:
0& ��' I L
RIGHT OF ENTRY ff
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 Signature: Date:
12� 3vvl'�—
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
CITY OF CARMEL RESIDENTIAL
RAIN BARREL COST SHARE APPLICATION
For Department of Storm Water Management Use
DATE RECEIVED: RECEIVED BY: j
I ham, J '
Target Area: 4APPROVED
COOL CREEK WATERSHED COST-SHARE AMOUNTAY75
CARMEL CREEK WATERSHED
_DENIED(Reason)
STAFF SIGNATURE: DATE:
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