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
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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
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• To make a credit card payment by telephone, call either: 317-232-5364 or 317-232-5388
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• 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