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HomeMy WebLinkAbout333100 12/11/18 \� CITY OF CARMEL, INDIANA VENDOR: 148000 ' ��• ONE CIVIC SQUARE INDIANA DEPT OF TRANSPORTATION CHECK AMOUNT: $****12,267.62* f. � CARMEL, INDIANA 46032 100 N SENATE AVE,RM IGC-N 725 CHECK NUMBER: 333100 INDIANAPOLIS IN 46204-2216 CHECK DATE: 12/11/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 202 4350900 50181 12,267.62 OTHER CONT SERVICES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 148000 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER , INDIANA DEPT OF TRANSPORTATION IN SUM OF$ CITY OF CARMEL 100 N SENATE AVE, RM IGC-N 725 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. INDIANAPOLIS, IN 46204-2216 Payee $12,267.62 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Terms Engineering Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 000050181 43-509.00 $12,267.62 1 hereby certify that the attached invoice(s), or 11/30/18 000050181 Des 1400937-96th Street and Priority Way $12,267.62 2200 202 2200 202 RAB Change Order 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 Friday, December 07,2018 Jeremy Kashman Director I hereby certify that the attached invoice(s), or bill(s), is(are)true and correct and]have audited same in accordance with IC 5-11-10-1.6 20 Clerk-Treasurer s Driving Indfa�raa's Ectao►»ic Growth l +DID 1.0.0 Nqo, ens W Avenua Ream IGC-N 743 Eric Fto[ao" gbvenfor Joss PAc�uinaass C�manciateeir T to arra t ,laid *204-221G Bill To: Customer No: CST000001811 Invoice: 000050181 City of Carmel 505 00 Invoice Date: 11/30/2018 ATTN: Jeremy Kashman Invoice Type: LPA One Civic Square Carmel IN 46032 --- --- - - — --- ►MOUNT ®UE:-_ ----$121.b-7:62 *** Payment is Due Upon Receipt of Invoice,*** Line Product Description Quantity Unit Amt Net Amount 1 DES1400937 CO 1.00 12,267.62 12,267.62 change order DES1400937 Intersection Improvement Roundabout on ST1065 96th St and Priority Way Greenfield District Subtotal: , 12,267.62 Amount Due: 12,267.62 Payment Options See Reverse Side For billing questions regarding DSP invoices call 317-234-5113;All other invoice types call 317-234-7727 INDIANA DEP T NT' F TRA -TION INVOIC9 � 1i�lUastttenaie�Avent�. Enc Nofc4rab'oove'nwr rs lc5 vapor .lhdii rw 46204-221 fast Pitc`Gu�iia sa;Camini�siatia� • To make a credit card payment by telephone, call either: 317-232-5364 or 317-232-5388 --------------------------------------------------------------------------------------------------------------------------------------------------------------- • OR RETURN THIS PORTION WITH YOUR PAYMENT Department of Transportation Invoice: 000050181 Attention: Agent Cashier - N749 IGCN Amount Paid $ 12, 2 t•-4 100 N. Senate Ave. Indianapolis, IN 46204 Visa ❑Mastercard Discover Check/Money Order Name on Card Card Number (Name must appear as exactly as on card) CID(3 or 4 digit security code) Expiration Date Billing Address Signature Required: Date For billing questions regarding DSP invoices call 317-234-5113;All other invoice types call 317-234-7727