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CITY OF CARMEL, INDIANA VENDOR: 369066
a, ONE CIVIC SQUARE FOUNDATION BUSINESS SYSTEMS LLCCHECK AMOUNT: S*******584.00*
xa, ,ate CARMEL, INDIANA 46032 15 SOUTH 5TH STREET CHECK NUMBER: 331 169
SUITE 500 CHECK DATE: 10/17/18
MINNEAPOLIS MN 55402
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 R4350900 32935 151270 584.00 STORMWATER INSPECTION
VOUCHER NO. WARRANT NO. Prescribed by state Board of Accounts City Form No.201 (Rev.1995)
Vendor# 369066 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
FOUNDATION BUSINESS SYSTEMS LLC IN SUM OF$ CITY OF CARMEL
431 FIRST AVE NORTH SUITE 410 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.
MINNEAPOLIS, IA 55401
Payee
$584.00
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
32935 151270 43-509.00 $584.00 1 hereby certify that the attached invoice(s), or 10/3/18 151270 ESC Quarterly Charges $584.00
2200 Encumbered 2200 2200 2200
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, October 17, 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
Remit To:
Foundation Business Systems, LLC Invoice
15 South 9th Street
Minneapolis, MN 55402
Invoice#: 151270
Invoice Date: 10/3/2018
Due Date: 11/2/2018
Bill To:
Project: PermiTrackESC
Kate Lustig
P.O. Number: 32935
City of Carmel zS00_ fL435'090b
Engineering Department
One Civic Sq
Carmel IN 46032
--Date--- - Description-- -- - ---Rate -- —Quantity - --Amount_- _
9/30/2018 Quarterly Service Fee based on New 89.00 6 534.00
Commercial Project Starts during the invoice
period July 1, 2018 through September 30,
2018.
9/30/2018 Quarterly Service Fee based on New 50.00 1 50.00
Residential Project Starts during the invoice
period July 1, 2018 through September 30,
2018
Please Note Address Change
Foundation Business Systems, LLC
15 South 9th Street
Minneapolis, MN 55402
Documentation Included
Thank you for your business. Total $584.00
Payments/Credits $0.00
Customer Service Contact:
tom.chambers@mypermitrack.com Balance Due $584.00
(612) 284-9410
Foundation Business Systems is an equal opportunity employer I www.mypermitrack.com
City of Carmel,IN ESC
July 1,2018 Through September 30,2018
3rd Quarter-2018
Ext.
Create End Point Access Project
Client Date Status Project Name Project Type Type SWMP Months Fee
City of Carmel,IN ESC 08/02/2018 Active Pearson Ford Parking Expansion Commercial N.O.T. Yes 6 $ 89.00
City of Carmel,IN ESC 08/21/2018 Active The Kent Commercial N.O.T. Yes 6 $ 89.00
City of Carmel,IN ESC 08/22/2018 Active Tom Wood Parking Lot Phase II Commercial N.O.T. Yes 6 $ 89.00
City of Carmel,IN ESC 08/22/2018 Active Meijer Outlot C Retail Commercial N.O.T. Yes 6 $ 89.00
City of Carmel,IN ESC 09/14/2018 Active Copperleaf Residential OCC Permit NO' 12 $ 50.00
City of Carmel,IN ESC 09/17/2018 Active IU North Cancer Center Commercial N.O.T. Yes 6 $ 89.00
City of Carmel,IN ESC 09/20/2018 Active World Wide Motors Commercial N.O.T. Yes 16 $ 89.00
$ 584.00
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