HomeMy WebLinkAbout331587 10/25/18 %`��'''�� CITY OF CARMEL, INDIANA VENDOR: 367204
ONE CIVIC SQUARE TSW UTILITY SOLUTIONS INC CHECK AMOUNT: $*•**68,058.00*
i� ® � CARMEL, INDIANA 46032 3120 W MORRIS ST CHECK NUMBER: 331587
+��TON�� INDIANAPOLIS IN 46241 CHECK DATE: 10/25/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1 68,058.00 OTHER EXPENSES
VOUCHER NO. 183084 WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev 1995)
ALLOWED 20
Vendor # 367204 IN SUM of$ ACCOUNTS PAYABLE VOUCHER
TSW UTILITY SOLUTIONS INC CITY OF CARMEL
197n n41nMA1Fc-r 8LvD-- ?3(910 NloR�lS 5 I An invoice or bill to be properly itemized must show: kind of service,where performed,
INDIANAPOLIS, IN qLdates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit,etc.
Payee
$68,058.00 367204 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR TSW UTILITY SOLUTIONS INC Terms
Carmel Water Utility 1970 MIDWEST BLVD Due Date
BOARD MEMBERS
I hereby certify that that attached invoice(s), INDIANAPOLIS,IN 46214
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
1 01-1060-02 $68,058.00 and received except 10/18/2018 1 -T $68,058.00
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
rsHr APPLICATION FOR PAYMENT
V�hSQdL/JOn9lnC .
Date: 5/25/2018
PO Number: Vendor-Invoice Number: 1
Vendor"/Contractor
Attn:Accounts Payable TSW Utility Solutions,Inc:
Jess Testerman,President
3120 W.Morris St.
Indianapolis,IN 46241
Carmel Water PM: Tel:(317)735-1491
96th&Haverstick to Day Road
Proiect Number. 0 Proiect Name: 96th&keystone Water Main Extension
DServicesi
0
Original Contract Amount: $. .151,784.00 Invoice Period Beginning:,
Change Order Amount: $ Invoice Period Ending:
Modified Contract Amount: $ 151,784.00
Total Work Completed to Date: $ 68,058.00
Less:Previous Payments: $ - ❑✓ Interim Payment ..
Amount Due This Request: $ 68,058.00 ❑. Final Payment
Please Pay This Amount: - $ 68,058.00'
Should you have any questions regarding this application,please refer them to Jess Testerman at(317)735-1491.
TSW Utility Solutions, Inc. (Contractor) certifies it has satisfied all of its obligations to its subcontractors, materialmen, equipment suppliers,vendors,and
employees for all labor performed, materials and equipment furnished, and services rendered to the Project whose work was incorporated on prior
Applications for Payment up to and including the date hereof.
CONTRACTOR further certifies that all lower-tier subcontractors and suppliers whose work in connection with the Project are incorporated in this Application
for Payment have been paid or will be paid by Contractor:upon or prior to payment to Contractor of the amountrequested herein.
L
By: By:
Carmel Water Project Representative TSW Authorized Representative
Terry L Ratliff-Project Manager
Printed Name and Title Printed Name and Title
5/25/2018
Date Date