Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
185954 05/26/2010
CITY OF CARMEL, INDIANA VENDOR: 00350969 Page 1 of 1 ONE CIVIC SQUARE SHIEL SEXTON COMPANY, INC CHECK AMOUNT: $233,272.96 CARMEL, INDIANA 46032 902 N CAPITOL AVE INDIANAPOLIS IN 46204 CHECK NUMBER: 185954 CHECK DATE: 5/26/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460807 2695 -35 233,272.96 PERFORMING ARTS CENTE i g k �Y March 31, 2010 ,kl G Mr. Les Olds, Director r Carmel Redevelopment Commission City of Carmel One Civic Square Carmel, IN 46032 RE: Parcel 7A, Regional Performing Arts Center Construction Management Services Shiel Sexton Job #2695 Payment Application 43 (March 2010) The following is a summary of Shiel Sexton's billable expenses: CM STAFF March 2010 2695 -35 220,538.00 CM GENERAL CONDITIONS March 2010 2695 -35 12,090.49 CM REIMBURSABLES March 2010 2695 -35 644.47 TOTAL DUE 233,272.96 If you have any questions please call me at 281 -1900 or our Accountant Lynda Weaver at 423 -6008. Sincerely, Michael G. Anderson Construction Manager Shiel Sexton Company, Inc. 902 North Capitol Avenue Indianapolis, IN 46204 Invoice Disbursement Schedule Contract: 2695- CARMEL PAC CONSTRUCTION Invoice: 2695 -35 3/31/10 Item: 10 CM Staff Labor GROUP MANAGER 50.00 Hrs $110.00 5,500.00 IT CONSULTANT 6.00 Hrs $90.00 540.00 PROJECT COORDINATOR 200.00 Hrs $65.00 13,000.00 PROJECT COORDINATOR 50.00 Hrs $65.00 3,250.00 PROJECT ENGINEER 492.00 Hrs $80.00 39,360.00 PROJECT MANAGER 334.00 Hrs $110.00 36,740.00 SAFETY MANAGER 30.00 Hrs $100.00 3,000.00 SR PROJECT MANAGER 326.00 Hrs $110.00 35,860.00 SUPERINTENDENT 608.00 Hrs $105.00 63,840.00. TOTAL Labor 2,096.00 hours 201,090.00 Material J MB ASSOCIATES 171 5,248.00 J MB ASSOCIATES 172 4,920.00 TOTAL Material 10,168.00 Subcontract SAFETY MANAGEMENT GROUP OF INDIANA, INC APL0222695 9,280.00 TOTAL Subcontract 9,280.00 Item: 10 CM Staff 220,538.00 Page 1 of 3 Invoice Disbursement Schedule Contract: 2695- CARMEL PAC CONSTRUCTION Invoice: 2695 -35 3/31/10 Item: 20 CM General Conditions Material ADT SECURITY SYSTEMS 20812837 106.73 AT T 22510 -2695 111.02 BLUELOCK 1643 2,959.74 CARMEL INK TONER 2866 63.09 CDW DIRECT, LLC RXH5557 75.60 DOCUNET ONLINE INC. 46 250.00 FAST SIGNS 98 -68885 66.88 ICE MOUNTAIN SPRING WATER O000121103790 188.13 IKON FINANCIAL SERVICES 81689773 435.49 ROBERTS 188.22 MOD SPACE 105334001 695.98 MOD SPACE 105334002 2,039.55 OFFICE DEPOT CREDIT PLAN 5108393434002 31.66 OFFICE DEPOT CREDIT PLAN 510839434001 418.96 OFFICE DEPOT CREDIT PLAN 511155795001 (32.74) OFFICE DEPOT CREDIT PLAN 511155797001 59.89 OFFICE DEPOT CREDIT PLAN 512975781001 47.99 OFFICE DEPOT CREDIT PLAN 512975881001 22.14 QW EST 1093128340 2.83 SSC IT 1,287.86 SPEEDWAY SUPERAMERICA LLC 30810 1,043.40 TW TELECOM 3452818 1,668.07 WILLIAM CALE PHOTOGRAPHY 257 360.00 TOTAL Material 12,090.49 Item: 20 CM General Conditions 12,090.49 Page 2 of 3 Invoice Disbursement Schedule Contract: 2695- CARMEL PAC CONSTRUCTION Invoice: 2695 -35 3/31/10 Item: 30 CM Reimbursables Material BLACK TIE COURIER, LTD. 30110 16.00 FEDERAL EXPRESS CORPORATION 5- 728 -01633 16.54 REPRO GRAPHIX, INC. 102220 15.73 REPRO- GRAPHIX, INC. 102370 596.20 TOTAL Material 644.47 Item: 30 CM Reimbursables 644.47 Summary 10 CM Staff 220,538.00 20 CM General Conditions 12,090.49 30 CM Reimbursables 644.47 CURRENT DUE: 233,272.96 Page 3 of 3 i It Invoice DATE INVOICE 3/5/2010 171 BILL TO SHIP TO Shiel Sexton Company J &MB Associates 902 North Capital Ave Atten: Marty Talbott 209 Lucky Lane Indianapolis, Indiana 46204 Pendleton, IN 46064 DUE DATE PA, NUMBER 3!12/2010 2695 -0004 ITEM DESCRIPTION QTY RATE AMOUNT Consulting Consulting Services for Project Management Master 64 82.00 5,246.00 Services Planning Scheduling for Carmel PAC during the weeks ending 02/25/2010 and 03/05120 1 0 i i I i I i i i I I Thank you for your business! Subtotal 5,248.00 0% TAX i Total 5.248.00 r ti Inv oice DATE INVOICE 3/19/2010 172 BILL TO SHIP TO Shiel Sexton Company J &MB Associates 902 North Capital Ave Atten: Marty Talbott 209 Lucky Lane Indianapolis, Indiana 46204 Pendleton, IN 46064 DUE DATE P.O. NUMBER' 3/2612010 2695 -0004 ITEM DESCRIPTION QTY RATE AMOUNT. Consulting Consulting Services for Project Management Master 60 82.00 4,920.00 Services Planning Scheduling for Carmel PAC for the weeks ending 03 -12 -2010 and 03 -19 -2010 i i Thank you for your business! Subtotal 4,920.00 0% TAX 1 Total 4,920.00 `APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 PAGE ONE OF 2 PAGES 70: Shiel Sexton PROJECT: Carmel Performing Arts Center APPLICATION NO: 0022 902 North Capital Indianapolis, IN 46204 PERIOD TO: 2/1512010 3/14/2010 VIA (ARCHITECT): FROM: Safety Management Group 6500 Technology Center Drive, Suite 200 JOB# Contract #26954004 Indianapolis, IN 46278 CONTRACT FOR: Safety Services CONTRACT DATE: Max 30, 2008 Application is made for Payment, as shown below, in connection with the contract. CONTRACTOR'S APPLICATION FOR PAYMENT Continuation Sheet, ALA Document G703, is attached. 7, ORIGINAL CONTRACT SUM 266,800.00 CHANGE ORDER SUMMARY 2. Net change by Change Orders 0.00 Change Orders approved In ADDITIONS DEDUCTIONS 3. CONTRACT SUM TO DATE (Line 1 +or- 2)... 266,800.00 prevtous months by owner 4. TOTAL COMPLETED STORED TO DATE 229,701.55 TOTAL $0.00 $0.00 (Column G on G703) Approved this Month 5. RETAINAGE: Number Date Approved a. 10 of Completed Work 0.00 1 (Column D E on G703) 2 b. 0 of Stored Material S 3 (Column F on G703) 4 5 Total Retainage (Line 5a 5h or TOTALS $0.00 so.00 Total in Column I of G703) 0.00 Not change by Change Orders so.00 6. TOTAL EARNED LESS RETAINAGE 229,701.55 The undersigned Contractor certifies that to the best of the Contractor's knowledge, (Line 4 less Line 5 Total) information and belief the Work covered by this Application for Payment has been 7. LESS PREVIOUS CERTIFICATES FOR completed in accordance with the Contract Documents, that all amounts have been PAYMENT (Line 6 from prior Certificate S 0.00 paid by the Contractor for Work for which previous Certificates for Payment were 8. CURRENT PAYMENT DUE S 9,280.00 issued and payments received from the Owner, and that current payment shown 9_ BALANCE TO FINISH, PLUS RETAINAGE 37,098.45 herein is now due. (Line 3 less Line 6 State of: Indiana County of: Johnson CONTRACTOR: Subscribed and sworn to before me this day of 2007. Notary Public: By: Date: My Commission Expires ARCHITECT'S CERTIFICATE FOR PAYMENT AMOUNT CERTIFIED In accordance with the Contract Documents, based on on -site observations and the (Attach explanation if amount certified differs from the amount applied for.) data comprising the above application, the Architect certified to the Owner that to the ARCHITECT: best of the Architect's knowledge, information and belief the Work has progressed as By: Date: indicated, the quality of the Work is in accordance with the Contract Documents, and This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the the Contractor is entitled to payment of the AMOUNT CERTIFIED. Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. G702 -1983 APPLICATION NO: 0022 Safety Management Group APPLICATION DATE: 3/2312010 PERIOD TO: 2115t20110-3/14120110 A D E F G H J WORK COMPLETED TOTAL BUDGET DIVISION OF WORK Original Revised TOTAL PREVIOUS THIS STORED COMPLETED RETENTION BALANCE SCHEDULED SCHEDULED SCHEDULED APPLICATION PERIOD MATERIAL STORED COMP TO VALUE VALUE VALUE TO DATE COMPLETE Safety Services $266,800.00 $0.00 $266,800.00 $220,421.55 $9,280.00 $0.00 $229,701.55 86% 50.00 $37,098.45 TOTALS $266,800.00 $0.00 $266,800.00 $220,421.55 $8,280.00 $0 $229,701.55 86% $0.00 $37,098.45 i 1 Purchase; NED 03/06/10 20812937 $106.73 04101!10 4 a Customer Number: Se N ature D t e s:�� 01300 1041 17053 Business/Account Name: C urrent SHIEL SEXTON 04/30'10 L qujTinp .,Scr vie e Service Address: 777 3rd Ave SW A �iW6.73: "M, 0 Carmel, In 46032 7 6: D ue 1 Total Billing Questions: (888y238-2455 ai r u reAo,,j;jfe- [a -e �yo your i p-v_Qj!C id" Sales /Relocation: (900) 238-7887 Mouitoring/Service:(800) 238-2727 "p.tO ciess.i 4— R",C'PaP ADT Tax ID Number: 58-1814102 low to Read Your MR; th Y. P ayment t'j) C usto m er http://www.adt.com/billinfo ;u; b er Invoice 1\`urn, IW� It's fast and even more important it's easy! You can 4, save time and money paying your bill. Please see the back of your invoice to see how you can setup your account for automatic payments using your bank account! Y Visit www.ADT.com for up-to-date security services information for your L: business. 5,� permitted p, y law, t 0 Ky.- To pay this i nvoice and/or future P W P, e recurring Ing invoices by credit Card, assesse follow the instructions on the "30 d' Y 7 back of this invoice. 'T YOUR ALARM SYSTEM MONTHLY TO CONFIRM YOUR SYSTEM IS OPERATIONAL Page I of I Payment Coupon Please detach and enclose this coupon with your payment, Do not Invoice Number: 20812837 send cash. Please write your customer number on your check or Invoice Date: 03/06/10 money order and make payable to: ADT Security Services. Customer N umber: 01300 104117053 Due Date: 04/01/10 If you want to pay by credit card or make any changes to your billing or service account information, please check here and enter the new Please Pay information on the back of this invoice. This Amount �10 6.�73 23265 1 AT 0.357 OC23265 S1 T90 Amount Enclosed: #BWNKFYG To ensure timely, accurate application to your account, 19Xi-'; #350711401003104# PLEASE INCLUDE THIS STUB. V SHIEL SEXTON 11 3c ATMACCOUNTING V MAIL PAYMENTTO V 902 N CAPITOL AVE ACT SECURITY SERVICES INC. INDIANAPOLIS IN 46204-1005 P.O. BOX 371967 PITTSBURGH, PA 15250-7967 1 11 'l l "11!'! "111'1' 00104117❑53D❑❑2❑81283700401100OU01OL73❑❑❑0106738 SHIE; qXION Page 1012 ACCIS PAYAULE 3011 d2695 Account Number 317 575 376 B 9D2 N CAP110L AVE Billing Date Feb 25. 2010 INDIANAIIDUS. IN 46204-1005 Web sile att.corn at &t luvoice Number 317575846402 D �C t 11•. 1111 ly Statement J an 26 Feb 25, 201 Nk Previous Bill 220.37 Pro n moons and Discounts Payment Received 2-15 Thank You! 220.37CR No. 005Uipti011 Disc ount for Ferm Voluirw fliscount Plan for Adjustments .00 Bill Period Feb 25, 2010 1,50CR Balance .00 Monthly Seevi" Feb 25 thru Mar 24 Monthly Charges 35.56 Current Charges 11 1,02 §q(cha!!Bes ago 9-1-1 Total Amount Due $111.02 Bille Emergency System for Itainifton County 2.00 Federal Universal Service Fee .78 Amount Due in Full by Mar 19, 2010 IN Universal Service Surcharge .15 IN Utility Receipt Surcharge .49 Telec01111"(1fliC[lbDres Relay Service .03 Total Surcharges and Other Fees 3.45 ll=�M EMM1,10 Taxes Questions? Visit att.com Federal at3% 1.03 State at 7% 2.49 Plans and Services 41.03 Total Taxes 3,52 1-800-480-8DBB Repair Service: Total Plans and Services 41.03 1-800-727-2273 AT&T Internet Services 69.99 1-877-722-3755 For Billing lnquiries� Total of Current Charges 111.02 AT&T High Speed interriet (DSO customers call 1.800.283.2020. AT&T Yahoo! Web Hosting customers call I-806.722.9937. AMT Web llostiugM (Shared Hosting, Virtual Dedicated Server (VDS) and Managed Dedicated Server (MDS)), call 1.888.932.4678. AT&T Wi-5 contact information located at attyAli.coin, 1!qmized Charges and Credits No -Qatq escti tion DescTi Services for 25104870 1239.8.375,128136 1 AV 0.335 111111111111111 Jill Jill I jilkll illf 111 Belli SHIEL SEXTON ACCTS PAYABLE JOB 92695 902 N CAPITOL AVE INDIANAPOtiS IN 46204-1005 f blu Invoice Date 1/112010 Invoice 1643 6325 Morenci Trail Acct. No, C3681 Indianapolis IN 46268 Terms Net 10 United States Due Date 1/11/2010 PO Start Date End Date Bill To Tim Malarney Shiel Sexton 902 N. Capitol Ave. Indianapolis IN 46204 5 y E- iYaiF..._ Yt.44'.+ L3{+' 1.5 VC-INTERNET I Virtual Cloud, Internet (Mb) 1.5 VC.RTR.A Virtual Cloud, Router, Advanced (Ea) 1.5 VC.FW.A f i Virtual Cloud, Firewall, Advanced (Ea) 3 VC.00RE.2x2 Virtual Cloud, (2x2 Core) Processor and Environmentals 3 VC.VM.MS.S3.32 Virtual Cloud, VM, Microsoft, Std 2K3 Svr, 32 Bit 3 j VC.MS_SQL5.S.32 Virtual Cloud, Microsoft, SQL 2005 Std, 32 Bit r 12.0 VC_SAN.PROD Virtual Cloud, SAN, SAS, Production (GB) 120 VC.SAN_BU Virtual Claud, SAN, Offsite Backup (GB) f l January February March 2010 Carmel Subtotal 4,155.75 Discount (DISC) 1,196.01 Total 2,95934 Amount Due $2,959.74 i I i i i Carmel Ink Toner Invoice 106 W Carmel Drive Carmel, rnT 46032 Date Invoice 3/16/2010 2866 Bill To Ship To Shed Sexton Performing Arts Studio 902 N. Capitol Ave Indianapolis, IN 46204 P.O. Number Terms Rep Ship Via F.O.B. Project net 30 days MM 3/1 6/2010 Quantity Item Code Description Price Each Amount 1-11- R88 C !-1C HP 88 Compatible Cyan Ink Cartridge 100% Guarantee 14C 9.99 9.99'1' HP R88 M XL 1 -11' 88 Compatible Magenta Ink Cartridge 100% Guarantee 9.99 9.99!" HP R88 Y I IC 1-I1' 88 Compatible Yellow Ink Cartridge 100% Guarantee 1-IC 9.99 9.99T 1 -11 R88XL B 1-11 88XL Compatible 131ack Ink Cartridge 100% Guarantee 28.99 28.99T Indiana Sales Tax 7.00% 4.13 Total r$63 .09 The Right Technology. M, M rerl M a M t s Right Away. 03/04/2010 RXH5557 NET 30 bays 04103/2010 VISIT CDW ON THE INTERNET www.cdw.com OUR PART NO DESCRIPTION UNIT PRICE 'QTY QTY ,QTY ORD SHIP B/O TOTAL 1068671 KINGSTON 2GB DDR2 667 1 1 0 $62.04 $62.04 Manufacture Part Number: KTD INSP60000/2G Beginning of customer text Wenzler Laptop Memory End of customer text. i F B y HAVE QUESTIONS ABOUT YOUR ACCOUNT? PLEASE EMAIL US T; credit @cdw.c m VIA PURCHASE ORDER NO, CUSTOMER NO. 03!0412010 FEDEX Ground 2695-01207 1411U49 PRODUCT. SUBTOTAL $62.04 I. SALESPERSON SHIP TO: SALES ORDER NUMBER SHIPPING TRENT CLEMEN SHIEL SEXTON COMPANY INC. $8.62 312 705 6216 ATTN:ERIC STONE SALES 902 N CAPITOL AVE 1 Bi JC4K $4 94 trencle@cdw.com n4nIANAPOLIS IN 46204.1005 TAX INVOICE: $75.60 AMOUNT COW DIRECT, LLC, AN ILLINOIS CORPORATION FEIN 36- 4530079 Illllllllll�ll! IIf ',IIIVIIIIII'dl'1Gi1111Vf11!IV IILIJII IIAQIIYIII[llll AMOOT DUE $75.60 65230DII MAKE CHECKS PAYABLE TO: PLEASE DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT �m CDW Direct, LLC INVOICE.NUMBER INVOICE DATE CU$TAMEth'NUMBER. PO Box 75723 A fgh l Chicago, IL 60675 -5723 RXH5567 03/0412010 1411049 Bishi Away."' PRODUCT SUBTOTAL SHIPPING SALES TAX RETURN SERVICE REQUESTED $62.04 $8.62 $4.94 INVOICE AMOUNT III�IIIIIII1111R1111I1111111II11iIIIF1111 AMOUNT DUE $75.60 575.60 r 0202 I ii�IIIIII��� I�I�nllfnn l illrll aili l lrinlllr �,l Il, lily „III, III, r, l �ul i SHIEL SEXTON COMPANY INC. CDW DIRECT, LLC ACCOUNTS PAYABLE PO BOX 75723 902 N CAPITOL AVE CHICAGO, IL 60575 -5723 INDIANAPOLIS, IN 46204 -1005 2VP15MX6X_1.2 PAGE: 1 of 1 16417- PO78 "TVP15JL50001454 Invoice Docunet Online, Inc. 10019 Windward Pass Fishers, Indiana 46037 317-435-4681 Bill To: Shid Sexton Company attn: Linda 902 N. Capitol Ave Indianapolis, Indiana 46204 Date Invoice No. P.O. Number Terms Due Date Project 03103110 46 Net 30 04/02110 Item Description Amount M Service Agreement Monthly Docunet Service Fee 250.00 Carmel Performing Arts Center March Thank You Total $250.00 1 E N S ryf INVOICE: 98- 68885 ',s.v Page 1 of 1 Invoice Date: 211512010 Date Ordered: 2/11/2010 2:59:36PM FastSigns Phone 317 -845 -5051 Due Date: 211512010 Time: 5:00:OOPM 4026 East 82nd Street, Suite Al2 Fax. 317- 845 -4428 Salesperson: Jamie Chowning Indianapolis, IN 46250 Email: 98 @fastsigns.com Entered By: Jamie Chowning Salesperson: jamie.chowning @fastsigns.co Date Printed: 2/15/2010 PO Ali will send s Project Description: Hard Hat Decals: Shiel Sexton Rust Logo (S) �a.� 9 Customer: Shiel Sexton Co. 902 N. Capitol Ordered by: Ali Wuensch Indianapolis, IN 46204 Phone: (317) 423 -6140 Fax: (317) 423 -6300 Email: awuensch @shielsexton.com PRODUCT DESCRIP QTY SIDES SIZE UNIT COST TOTALS ECO PRINT ONLY (No L Eco-Solvent Vinyl Print NOT 50 1 2.25 x 2 $1.25 $62.50 Laminated, NOT Mounted. Color: Full Color Text: Shiel Sexton Rust Logo i Notes: Thank you for your continued business! You are very important to us. Turn around is approximately 1 2 business days from order approval. Other Payments: Form of Payment Amount Initials Line Item Total: $62.50 TERMS:- All payments are Net 30, A Finance charge of 2% per month 124% per annum will be Subtotal: $62. added to all past due Invoices. CUSTOM SIGNS ARE NON REFUNDABLE. All Signs Taxes: $4.38 remain the property of FastSigns until paid in full. agree that FastSigns can remove Total: $66.88 said siqns if not paid accordinq to the terms on this order. Total Payments: $0.00 RECEIVEDIACCEPTED BY DATE Balance Due: $66.88 Bill To: Shiel Sexton Co. I Attention: All Wuensch 902 N. Capitol Indianapolis, IN 46204 Copyright 2005 FASTSIGNS International, Inc Open Monday Friday 8:30 6:001 Closed Weekends I SYSTEKFASTSIGNS_CRYSTAL Inv6ce -FII01 service.icernountain.corn #215 6661 DIXIE HWY SUITE 4 0.' 7 ►iG3 4s s r t LOUISVILLE KY 40256 02/07/10 3/06110 60001211 Q3790 ADDRESS SERVICE REQUESTED 111I11 E I 1 FR RI- I- MAR 18 0121103790 MAR 26 MON- APR 05 #BWNNWYR MON- APR 12 90400001211037902# SH!EL SEXTON DOUG ADAMS Customer Service: 1- 800 -472 -9888 902 N CAPITOL AVE INDIANAPOLIS IN 462041005 Thank you for choosing Ice Mountain Home Office Delivery! We value your business. r�urt Lt rru r l( r lr r,(r,(uru(ir,rlr(r „,I�„I,i,r� 7 az�• ter; ,t 3 i i I ACCOUNT ACTIVITY Pay your bill online atrservice.icemountain.com or by phone at: 1-000-472-980. Ifs free! i Delivery address: SHIEL SEXTON, 7773RD AVENUE SW, CARMEL IN 46032 3104 06626646B9 2 6 OZ. STYROFOAM HOT CUPS 2.78 4 5 GAL ICE MOUNTAIN DRK W/HANDLE 15.96 1 12 CUP COFFEE FILTER 50 COUNT .00 1 NESCAFE TASTERS CHOICE VANILLA 2.49 NATURAL<;SFRING'_Wl�TER..ICE MTIV 5.49 i SUGAR CANI 1 /2;D OZ 1 99 1 CARNATION .COFFEE -MATE 1't OZ 2 29 1 NESCAFE P130MOxI0N .00 1 NESCAFE TASTERS CHQICE ORT.GIN/{L'.. 2 49 1 NEWPORT COFFEE 113ApEK HOUSE BLEND 30.99 1 9 OZ PI ASTIG -`•UP SQCjSLEEVE; 1 .79 BOTTLE DEPOSIT 4 CHARGED:, 2 CREDITED 00 3 /0(i 0664169950 i OILjFUEL SUF3CHARGE C8972140 RENT 2.24 15.98 SALES TAX C 3.09 TOTAL v nT q ACCOUNT SUMMARY PREVIOUS BALANCE, PAYMENT /ADJUSTMENT_ C RRENT rTY PAY THIS AMOUNT p-'i'S'ubject to terms on reverse side. 301.46 301,46 T 3 188.13 Detach this s0ub and return with your payment ACCOUNT NUMBER PAY BY PAY THIS AMOUNT P.O. BOX 856680 0121103790 3/28/10 188.13 Louisville, KY 40285 6680 INVOICE NUMBER BILLING DATE AMT. ENCLOSED 0000121103790 03/09/10 407201211037901 0018813 00188135 5 ICE MOUNTAIN SHIE=L SEXTON a Division of Nestle Welers North America Inc. DOUG ADAMS P.O. BOX 856680 902 N CAPITOL AVE I Louisville, KY 40285 -6680 INDIANAPOLIS IN 462041005 u.. Itr r rlr�I r II IIIrtlllt r111tI��,,Irt�rlrrrllr tr FOR CUSTOMER SERVICE CALL 1- 800 472 -9888 SIGN UP FOR FREE AUTOPAY! Sign Up Required On Reverse Side. Print Any Changes On Reverse Side, (QESP )30:TO09:002544:002:1000:ICM11 R 040 90 N 1 0 E 01 r M- irF_nnnnurnini__. PLEASE RETURN THIS REMITTANCE PORTION WITH YOUR PAYMENT lam 0 3/26/2010 ACCOUNT 03/05/2010 107&031 06 Your import to 4x us Please use space provided on G- PLtASE REFER TO ACCOUNT NU MSFP the reverse side. 81 689773 ON ALL iNQUIRIE5... P.LEASE.DO NOT STAPLE OR FOLD THIS PORTION 1B $435.49 f l Address wrr�diou requoled. (Fkase completer er5z s de.l e 3c I T ATTN: ACCOUNTS PAYABLE T IKON`FINANC AL.SERVICES' t a SHIEL SEXTON COMPANY 2NC M o PO :BOX.; 74054 Z L 902.. N CAPITOL AVE AT7IANTA GA 30374. -0541 INDIANAPOLIS IN 46204_1.0`.05:..' I��II�lI�����ILI, ��Irl��llhi i�lilc�fiifrnlli l�rE� <<i {LJ�I, 01 0000000010760312 0000816897737 0000000000435495 I�.�3�U F If1aT1 CI a ISer VICes�� r'r'r� 81689773 PO G- Late charges will be assessed if O BOX 9115 e M A 3}208 9115 paymenf is not received by the due rT. r 03 0 5/2010 date. ACCOUNT 03/26/2010 NUMBER: 1076031- 2233906 18 SHIEL SEXTON COMPANY INC For billing inquiries, please call Customer service at I T ATTN: ACCOUNTS PAYABLE number printed below. Please refer to account number on L 4 902 N CAPITOL AVE all inquiries. INDIANAPOLIS IN 46204 -1005 PLEASE CALL 1- 800 595 -1011 FOR ACCOUNT INQUIRIES OR FAX TO 1- 478 -405 -4026 RENT 407.00 STATE TAX 28.49 $435.49 KM -5050I BUNDLE C24010892 CURRENT BILLING PERIOD:.03 /26/2010 04/25/2010 PURCHASE ORDER NBR 2695 -01205 r FOR QUICKER PAYMENT PROCESSING YOU MAY PREFER ONE OF OUR ELECTRONIC PAYMENT OPTIONS: 1) AUTOMATED CLEARING HOUSE 2) ELECTRONIC FUNDS TRANSFER 3 CHECK BY PHONE PLEASE CALL THE NUMBER LISTED ABOVE. FOR ASSISTANCE IN LOCATING AND REPORTING METERS OR ORDERING SERVICE AND SUPPLIES CALL 1- 888 956 -6457 OR GO TO WWW.IKCN.COM AND CLICK bN THE CUSTOMER SUPPORT LINK I AR 10 70 T AT THE TOP OF THE PAGE. I ti By I I i I 435.49 0.00 0.00 0.00 $435.49 E. RETAIN THIS INVOICE PORTION FOR YOUR RECORDS I' unosY.¢o iooaostasor.orvw U� Iwo L9 1 1pK,`..... ��Qr3R�ti 1 0 OR f �t *I- i I M J 'l A C i i 1200 5wedesford Road Remittance S ection ,7 e Berwyn, PA 79312 Customer Number: 243159- 683878 Mod Invoice Number: 105334001 Invoice Due Date: 03/20/2010 INVOICE Address Service Requested Total Due; $695.98 Amount Remitted; Use enclosed envelope and make payable to: 0838003031 PRESORT MAAO P1 C13 <6> 3031 1 [1B 0.362 i l l I I I I I I I I I! II II I I I I I I II I Modular Space Corporation 12603 Collections Center Drive SHIEL SEXTON Chicago, IL 60693 -0126 LYNDA WEAVER E 902 N CAPITOL AVE 11111111„ 1111111, 1n1, 11111111 14111u1r11F1n11111 ,r111rIn11 INDIANAPOLIS IN 46204 -1005 0000069598 702431,59141105334001,6 i. Keep rower portion tar your records Please retum upper portion with your payment Customer Name: SHIEL SEXTON Invoice Number: 105334001 Customer Number: 243159- 683878 Total Due: $695.98 MoldSpaea Invoice Date: 03/10/2010 Tax ID: 54- 1375284 Invoice Due Date: 03/20/2010 INVOICE Important Messages Thank You for Your Business Get a C omplete Whether it's a mobile office storage container or a custom design building, ModSpace has a large selection of sizes floor plans in stock, ready for quick delivery and installation. office set in You can rely on us for one stop shopping for all your space needs! We can supply steps, ramps, furniture, f security and insurance for your work site. Ask about our "complete office set up in 1 day" offer....... i 866 322 -0120 or vast our website at www.modspace.com See reverse side for "How to Read Your Invoice" information °,ESC ?Tt:. Lease Number: 358372 PO Number: 2805.2002 0311612010- 04/15/2010 $600.00 Job: Contact: Doug Adams Location: Carmel Arts Center CARMEL,IN 46033 Unit(s):135557 12 X 70 DS19454 -A' j Unit(s):135558 12 X 70 0519454 -B 1 1 STEPS 03/1612010 04/15/2010 $20.00 Pre -Tax Sub Total $620.00 REIMBURSEMENT OF PROPERTY TAX $30.44 1N• State Tax 7% $45.54 Lease Total $695.98 Invoice Total 0 v 1�1d $695.98 i i PLEASE PAY THIS AMOUNT page 1 of 2 695.98 i *�`1 1200 Swedesford Road Retfiittance Section �r�,. Berwyn, PA 19312 Customer Number: 243159 683878 Mod acu Invoice Number: 105334002 Invoice Due Date: 03/20/2010 INVOICE Address Service Requested Total Due: $2,039.55 Amount Remitted: Use enclosed envelope and make payable to: 08380 03032 PRESORT MAAD P1 C13 <0> 30322 1 MIR 0.382 Modular Space Corporation 12603 Collections Center Drive SHIEL SEXTON Chicago, IL 60693 -0126 LYNDA WEAVER 902 N CAPITOL AVE INDIANAPOLIS IN 46204 -1005 0000203955002431591411 ,05�340©27 Keep lower portion for your records Please refum upper portion with your payment Customer Name: SHIEi_ SEXTON Invoice Number: 105334002 Customer Number: 243159 683876 Total Due: $2,039.55 MWSpace Invoice Date: 03/1012010 Tax ID: 54- 1375284 Invoice Due Date: 03/20/2010 INVOICE Important Messages Thank You for Your Business Get a c omple te Whether it's a mobile office storage container or a custom design building, ModSpace has a large selection of sizes floor plans in stock, ready for quick delivery and installation. office set -up inn You can rely on us for one stop shopping for all your space needs! We can supply steps, ramps, furniture, security and insurance for your work site. Ask about our "complete office set up in 1 day" offer....... A 866- 322 -0120 or vist our website at www.modspace.com See reverse side for "How to Read Your Invoice" information r Irs_�R Lease Number 390024 PO Number: TBD 0212112010 03/20/2010 $1,750.00 Job: Contact: Doug Adams j Location: Carmel Performing Arts Center CARMEL ,IN 46033 I Unit(s):602407 12 X 72 31517 Unit(s):602408 12 X 72 31518 Unit(s)7 602409 12 X 72 31519 Unit(s):602410 12 X 72 31520 Unit(s):602411 12 X 72 31521 4 STEPS 02/21/2010 03/2012010 $80.00 Pre -Tax Sub Total 51,830.00 REIMBURSEMENT OF PROPERTY TAX $76.10 1 IN- State Tax 7% I a i 33.45 Lease Total $2,039.55 i Invoice Total 01 PLEASE PAY THIS AMOUNT $2,039.55 page 1 of 2 ORIGINAL INVOICE u is PO B Dep 30 Inc PO BOX 630813 THANKS FOR YOUR ORDER D CINCINNATI OH IF YOU HAVE ANY QUESTIONS 45263 -0813 OR PROBLEMS. JUST CALL US FOR CUSTOMER SERVICE ORDER: (888) 265 -3423 FOR ACCOUNT: (800) 721 -6592 FEDERAL ID:59- 2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER 510839_434002 31.65 Pa e 1 o 1 INVOIC DAT TERM PAYMENT D 02- MAR -10 Net 30 03- APR -10 BILL TO: SHIP T0: A77N:ACCOUNTS PAYABLE SHIEL SEXTON CONSTR OFFICE SHIEL SEXTON CO INC 902 N CAPITOL AVE ATTN DOUG ADAMS INDIANAPOLIS IN 46204 -1005 cc 777 3RD AVE SW o Ste= CARMEL IN 46032 IILILII, I, tLIIL IIfi11111I11101111II4I I lisle III Il ACCOUNT NUMB R PO JOB SHIP TO LD ORDER NUMBER ORDER ORTE SHIPPED DATE 35973913 2695 CARMELPAC 510839434002 26- FES -10 02- MAR -10 BILLING ID ACCO UNT MANAGER RELEASE ORDERED BY JDESKTOP ICSTCNTR 162198 GEOFF PRATT 01204 i CATALOG ITEM N/ DESCRIPTION/ U/M QTY QTY QTY UNIT EXTENDED MANUF CODE CUSTOMER ITEM tt TAX ORD Slip B/o PRICE PRICE _j 468815 TOWEL, ROLL, 12CA,NATURAIL CA 1 1 0 29590 29.59 1726A1 468815 Y m o 0 v f i� ;i SUB -TOTAL 29.59 DELIVERY 0.00 i I SALES TAX 2.07 All amounts are based on USD currency TOTAL 37.66 To return supplies, pLease repack in original box and insert our packing list, or copy of this invoice. Please note problem so we may issue credit or rep La cement, whichever you prefer. ?tease do not ship collect. Please do not return furniture or machines until you call us first for instructions. Shortage or damage east be reported within i days after delivery. A DETACH HERE A CUSTOMER NAME BILLING ID INVOICE NUMBER INVOICE INVOICE AMOUNT ENCLOSED DATE AMOUNT T CO INC 6219 510839434002 02- MAR -10 31.66 T SHIEL SEXTON C L FLO 001621986 5108394340026 00000003166 1 3 I Please OFFICE DEPOT Please return this stub widi your payment to Send Your PD Box 633211 ensure prompt credit. to your account, Check•to: Cincinnati OH 45263 -3211 Please DO NO`l' staple or fold. Thaiik You. i aO4a75•D9Di8a 00005100006 ORIGINAL INVOICE Of f ice O ffice Depot, 30813 THANKS FOR YOUR ORDER Po sax 630613 CINCINNATI OH IF YOU HAVE ANY QUESTIONS DEPOT 45263.0813 OR PROBLEMS- JUST CALL US FOR CUSTOMER SERVICE ORDER: (888) 263 -3423 FOR ACCOUNT: (800) 721 -6592 FEDERAL ID:59 2663954 INVOICE NUM BER AMO UNT D I P AGE NU MBER 5_1 083 9 43400 1 418.36 P ie 1 of 2 INVOI DAT TE RMS I PAYMENT D 01- MAR -10 Net 30 03- APR -10 BILL TO: SHIP TO: ATTN:A000UNTS PAYABLE SHIEL SEXTON CONSTR OFFICE `O SHIEL SEXTON CO INC g 902 N CAPITOL AVE ATTN DOUG ADAMS INDIANAPOLIS IN 4 6204 -1005 m 777 3RD AVE SW CARMEL IN 46032 Will 1 11114, 1t114llIlli lle ll1111 11111111611111111 V ACCOU T NUMBER 0 JOB SHIP TO ID ORDER NUMBER ORDER DATE S HTPP ED. DATE 3 ICARMELPAC 510839434001 26- FEB -10 01- MAR 10 BILLING ID ACCO MAN AGER RE LE SE ORDERED BY DESKTOP CSTCNTR f 16Z19H W GEOFF PRATT 0120E CATALOG ITEM W/ DESCRIPTION/ U/M CITY QTY QTY UNIT EXTENDED MANUF CODE CUSTOMER ITEM N TAX ORD SHP B/0 PRICE PRICE 508450 SPOON,PLASTIC,100CT,WHIT PK 1 1 0 4.650 4.85 11594 508450 Y 508506 FORK,PLASTIC,106CT,WHITE PK 1 1 0 4.820 4.82 11592 508506 Y 943472 LABEL, P /S,COPR,1.5X2 -13116 BX 1 1 0 31.220 31.22 5360 943472 Y 344352 BATTERY,ENERGIZER MAX PK 1 1 0 25.990 25.99 E91 SBP36H 344352 Y m m 210142 BATTERY,ALKAUNE,MAX,AAA, PK 2 2 0 12.990 25.98 8 E92S16F4T 210142 Y R 474395 SPRAY,Gi.ADE,COUNTRY EA 4 4 0 5. 290 2116 94760 474395 Y 765805 PAD,MEMO,WIREBOUND,TOP EA 20 20 0 1.990 39.80 99516 765805 Y 251368 TISSUE,BATH,ANGLSFT400SH CT 2 2 0 39.990 79.96 16640 251368 Y 348037 PAPER,COPY,8.5X11,104 BRT, CA 3 3 0 31.520 94.56 8510010/) 348037 Y 536648 PAPER,COPY,00,11X17,5CA,1 CA 2 2 0 35.590 71.18 i 8439230D 536648 Y i I CONTINUED ON NEXT PAGE... 004475- 000183 00003/006 ORIGINAL. INVOICE Office BOX THANKS FOR YOUR ORDER P 0 BOX 630813 CINCINNATI OH IF YOU HAVE ANY QUESTIONS P� 45263 -0813 OR PROBLEMS. JUST CALL US FOR CUSTOMER SERVICE ORDER: (888) 263.3423 FOR ACCOUNT: (800) 721 -6592 FEDERAL [D:59- 266395 4 INVOICE NUMBER AMOUNT DUE PAGE N UMBER 51083 418.96 Page 2 of 2 INVOIC DATE TERMS PAYMENT DUE 01 MAR 10 Net 30 i 03- APR -10 BILL TO: SHIP TO.: ATTN:ACCOUNTS PAYABLE SHIEL SEXTON CONSTR OFFICE o SHIEL SEXTON CO INC ATTN DOUG ADAMS q 902 N CAPITOL AVE w s r INDIANAPOLIS IN 46204 -1005 oc- 777 3RD AVE 5W C) CARMEL IN 46032 A: NT NUMBER PO JOB CARMELPAC 510839434001 ORDER 01-MAR-10 359T3913 2695 BILLING ID ACCOUNT M ANAGER RELEASE 0 DERE_D BY DESKTOP CSTCNTR 162198 �Y GEOFF PRATT 01204 I CATALOG ITEM P/ DESCRIPTION/ U/M QTY QTY OTY UNIT EXTENDED MANUF LODE CUSTOMER ITEM f! TAX QRD SHP B/0 PRICE PRICE m m U O I() d SUB -TOTAL 399.54 TIERED DISCOUNT DEL[VERY 0.00 SALES TAX 27.41 All amounts are based on USD currency TOTAL 418'96 To return supplies, please repack in original box and insert our packing list, or copy of this invoice.. Please note problem so we MY issue credit or repl.aceaent, whichever you profer. Please do not ship coLLect. Please do not return furniture ar machines until you call us firs[ for instructions. Shortage or damge oust be reported within 5 days after delivery. DETACH HERE a CUSTOMER NAME BILLING ID INVOICE NUMBER INVOICE INVOICE AMOUNT ENCLOSED DATE AMOUNT SHIEL SEXTON CO INC 162198 510839434DO1 01- MAR -10 418.96 I FLO 001621986 5108394340018 00000041896 1 7 I Please OFFICE DEPOT Please return this stub with your payment to Yfsur PO Box 633211 ensure prompt Credit to your account. Send Send Yo: Cincinnati OH 45263.3211 Please DO NOT staple or fold, Thank You. Mdd7fi.nnnl RR 00004 CREDIT MEMO looao 1Ce OITcf Inc Po s OX ox f; THANKS FOR YOUR ORDER CINCINNATI ON IF YOU HAVE ANY QUESTIONS 45263.0813 OR PROBLEMS. .LUST CALL US FOR CUSTOMER SERVICE ORDER: (888) 263 -3423 FOR ACCOUNT: (800) 721 -6592 FEDERAL ID: 59- 2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER 511155795001 -32.74 Page 1 of 1 INVOI DATE TERMS PAYMENT DUE 12 -MAR -1 O 12- MAR -10 BILL TO: SHIP T0: W ATTN :ACCOUNTS PAYABLE SHIEL SEXTON CO INC SHIEL SEXTON CONSTR OFFICE m 902 N CAPITOL AVE ATTN DOUG ADAMS n, INDIANAPOLIS IN 46204 1005 777 3RD AVE Sly o o CARMEL IN 46032 IfIq IIIII11111111111111311111 HI III III III d III IIII I II III II ACCOUNT NUMBER 1 PO JOB 9 ISHIP 0 ID IORDER ER DATE SHIPPED DATE 35973913 2695 CARMELPAC 511155795001 02- MAR -10 01- MAR -10 BILLING iD ACCOUNT MANAGER RELEASE ORDERED BY DESKTOP 5 C N ER 162198 IGEOFF PRATT 101204 E CATALOG ITEM N/ DESCRIPTION/ UIM QTY flTY QTY UNIT EXTENDED j MANUF CODE CUSTOMER ITEM N TAX DRO SHP B/0 PRICE PRICE 943472 943472 80X -1 -1 0 30.600 -30.60 5360 943472 Y A credit of $32.74 has been applied to Invoice 510839434001- E m i o I 0 SUB -TOTAL 30.60 DELIVERY 0.00 i I SALES TAX -2.14 All amounts are based on USD currency TOTAL -32.74 To return supplies, please repack in original box and insert our packing list, or copy of this invoice. Please note problem so we may issue credit or replacement, whichever you prefer. Please do not ship collect. Please do not return furniture or aachines until you call us first for instructions. Shortage or damage oust be reported within 5 days after delivery. DETACH HERE e CUSTOMER NAME BILLING ID INVOICE NUMBER INVOICE INVOIC E AMOUNT ENCLOSED DATE AMOUNT SHIEL SEXTON CO INC 162198 511155795001 12- MAR -10 32.74 *"DO NOT PAY I I, j I 004417.000319 Mlind!l1rY11 d ORIGINAL INVOICE ON Are Pc, OftDep6813 THANKS FOR YOUR ORDER OX 630613 IF YOU HAVE ANY QUESTIONS CINCINNATI OH OR PROBLEMS. JUST CALL US DEPOT 45263.0813 FOR CUSTOMER SERVICE ORDER: (558) 263 -3423 DEPOT ACCOUNT: (800) 721 -6592 FEDERAL ID:59 2663954 IN VOICE NUM AMOUNT DUE PAGE NUMBER 511155797001 59.89 Page aft_ INV OICE DAT T PAY DUE 03- MAR -1D Net30 03- APR -10 BILL T0: SHIP T0: ATTN:A000UNTS PAYABLE SHIEL SEXTON CONSTR OFFICE V SHIEL SEXTON CO INC ATTN DOUG ADAMS 902 N CAPITOL AVE INDIANAPOLIS IN 46204 -1005 cc 777 3RD AVE SW CARMEL IN 46032 ItJ�, LIIl��t1�111ttt�I�litt111111 oil lttffllltllt,tt11t1111t,1 ACCOUNT NUMBER p0 J6- SHI '0 TO ORDE NUMBER ORDER DATE 5H PPED DATE 35973913 2695 LARMELPAC 511155797001 OZ- MAR -10 03- MAR -10 BILLI G ID ACCOUNT MANAGER RELEASE ORD BY DESKTOP CSTCNTR GEOFF PRATT- 01204 Ulm OTY QTY QTY UNIT 1. EXTEN CA MANUF CODE DE CUSTOMER N ITEM b f— TAX ORD SHP B/C PRICE PI i 944272 LABEL, LSR,FILE,I500 PK 2 2 0 25.760 51.52 5366 944272 Y 203174 HIGHLIGHTER,MAJ DZ 1 1 0 4.450 4.45 25025 203174 Y W 0 0 0 0 `o o t SUB -TOTAL 55.97 DELIVERY 0.00 I SALES TAX 3.92 All amounts are based on USD currency TOTAL 59 To return supplies, please repack in original box and insert our packing list, or copy of this invoice. Please ante problem so we may issue credit or replacement, whichever you prefer. Please do not chip collect. Please do not return furniture or machines until you call us firs[ for instructions. Shortage or da..ge w.lst be reported within 5 days after delivery. A DETACH HERE A CUSTOMER NAME BILLING ID INVOICE NUMBER INVOICE INVOICE AMOUNT ENCLOSED DATE AMOUNT SHIEL SEXTON CO INC 162198 511155797001 03- MAR -10 59.89 I FLO 001621986 51115579700119 00000005989 1 2 Please OFFICE DEPOT Please return this stub with your payment to Send Your PO Box 633211 ensure prompt credit t0 your account. check to: Cincinnati OH 45263 -3211 i Please DO NOT staple or fold. Thank You. I 004475-0W168 00006/00008 f ORIGINAL INVOICE l0000 ic Office Depo PO BOX 630813 Off THANKS FOR YOUR ORDER CINCINNATI OH IF YOU HAVE ANY QUESTIONS 45263-0813 OR PROBLEMS. JUST CALL US FOR CUSTOMER SERVICE ORDER: (888) 263 -3423 FOR ACCOUNT: (800) 721 -6592 FEDERAL IDt59- 266395 4 INVOICE NUMBER AMOUNTDUE PAGE NUM 512975781001 47.99 Page 1 of 1 INVOICE DATE TERMS PAYMENT DUE 17- MAR -10 Ne130 17- APR -10 BILL TO: SHIP TO: ATTN:A000UNTS PAYABLE 9 SHIEL SEXTON CO INC SHIEL SEXTON CONSTR DEFILE g 902 N CAPITOL AVE ATTN DOUG ADAMS N INDIANAPOLIS IN 46204 -1005 777 3RD AVE SW 8 t7 CARMEL IN 46032 ACCOUNT NUMBER PO J0B SHIP TO ID ORDER NUMBER ORDER DATE SHIPPED DATE 35973913 2695 JCARMELPAC 1512975781001 16- MAR -10 17- MAR -10 BILLING ID ACCOUNT MANAGER RELEASE JORDERED BY I DESKTOP COST CENTER j 162198 GEOFF PRATT 01204 CATALOG ITEM DESCRIPTION/ U/M QTY QTY 11 UNIT EXTENDED MANUF LODE CUSTOMER ITEM TAX ORD SHP B/O PRICE PRICE 161594 PEN,BALL PT,MEDIUM,STICK,B DZ 3 3 0 1.210 3.63 33311 181594 Y 515061 PENCIL,MECH,TVVIST,BK,ERA EA 3 3 0 3.590 10.77 Q E519A 515061 Y 907424 SLEEVES,CD /DVD,50 /PK,ASTD EA 2 2 0 2.990 5.98 32021965 907424 Y 620650 CD- R,SPINDLE 80 MIN,IOOIPK PK 1 1 0 22.680 22.68 32024581 620650 Y 139632 LEAD,HB 9MM,BLK,3PK PK 1 1 0 2.240 2.24 54111 139632 Y' m 4 I N o p i y 1 1 it i "x SUB -TOTAL 45.30 TIERED DISCOUNT -0.45 DELIVERY 0.00 SALES TAX 3.14 All amounts are based on USD currency TOTAL 47.99 To return supplies, pLease repack in original box and insert our packing List, or copy of this invoice. Please note prab Lem so we my issue credit or reptaceaent, whichever you prefer. Please do not ship cottect. Please do not return furniture or machines until you catt us first for instructions. Shortage or dawage amt be reported within days after do Livery. DETACH HERE A CUSTOMER NAME BILLING ID INVOIC€ NUMBER INVOICE INVOICE AMOUNT ENCLOSED DATE AMOUNT SHIEL SEXTON CO INC 162198 512975781001 17- MAR -10 47.99 i j FLO 001621986 5129757810017 00000004799 1 9 Please OFFICE DEPOT Please return this stub with your payment to Send Your Po Box 633211 ensure prompt credit to your account. Check to: Cincinnati OH 45263 -3211 Please DO NOT staple or fold. Thank You. 1" I 004412. 000319 00013100014 r ORIGINAL INVOICE 10000 Office 630 1 J L3LIC 3 0 PoBO saoal3 THANKS FOR YOUR ORDER CINCINNATI OH IF YOU HAVE ANY QUESTIONS DEP 45263.0813 OR PR08LEHS. JUST CALL US FOR CUSTOMER SERVICE ORDER: (888) 263 -3423 FOR ACCOUNT: (800) 721 -6592 FEDERAL I D:59 2663954 INVOICE NUMBER AMOUNT DUE PAGE NUMBER 512975881001 22.14 Page 1 of 1 IN DATE TERMS PAYMENT DUE 17- MAR -10 Net 30 17- APR -10 BILL TO: SHIP TO: A7TN:AC000NTS PAYABLE SHIEL SEXTON CONSTR OFFICE r, SHIEL SEXTON CO INC 4 902 N CAPITOL AVE ATTN DOUG ADAMS 9 INDIANAPOLIS IN 46204 -10015 O7 777 3RD AVE SW v g CARMEL IN 46032 LLJIiI,,,,Llilltl, ill, l ,IllllllllllllillJllltllillJL,l ACCOU T NUMBER I PO JOB N SHIP TO ID ORDER MB R IORDER DATE ISHIPPED DATE 35973913' 2695 CARMELPAC 512975881001 16- MAR -101 17- MAR -10 BILLING ID ACCOUNT MANAGER RELEASE ORDERED BY DESKTOP ICOST CENTER 162198 GEOFF PRATT 01204 CATALOG ITEM N/ DESCRIPTION/ I U/M QTY QTY qTY UNIT EXTENDED MANUF CODE CUSTOMER ITEM >f TAX ORD SHP 9/0 PRICE PRICE 485985 HAND Y EA 10 10 0 2.090 20.90 809 485985 Y 3 SUB -TOTAL 20.90 TIERED DISCOUNT -0.21 DELIVERY 0.00 SALES TAX 1.45 All amounts are based on USD currency TOTAL 22.14 To return supplies, please repack in original her and insert our packing List, or copy of this invoice- Please note problem so we may issue credit or replacement, whichever you prefer. Please do not ship col tact. Please do not return furniture or machines unt1L you call us first for instructions. Shortage or damage ,oust be reported within S days after detivery. 0 DETACH HERE e CUSTOMER NAME BILLING ID INVOICE NUMBER INVOICE INVOICE AMOUNT ENCLOSED DATE AMOUNT SHIEL SEXTON CO INC 162198 512975881001 17- MAR -10 22.14 I FLO 001621986 5129758810016 00000002214 1 0 Please OFFICE DEPOT Please return this stub with your payment to Send Your PO Box 633211 ensure prompt credit to your account. Check to: Cincinnati OH 45263.3211 Please DO NOT staple or fold. Thank You. „nap,, ,w,,,�, a nnnf euimi e r Q we S t. 4• March 11, 201D SHiEL SEXTON Saldl el Sanlc.• Invoice 1093128340 Account 61952158 Page S of 140 Your Account Balance (continued) Currant Nei Charges (conlinued) SHIELSEy4TON 139845699 pwesl Total A SS. SE R EGION 1407569/19 Owes! Total Adva I L C C Currant gross charges 2,45 Other Fee Munthly Ch arges 0. Fed e ral U Service Fund 0 -35 M Fed Telecom Rela Servic p 03 K JOB.*296 C ARMEL PA C 140757433 O west Total Advarlage Currenl gl charges 5 O ther Foot M onthly Char p•3 Fed eral Un iversal Service Fund 0.35 Fad Telecom Relay Service 0.03 $2.83 LR #35 25 1 Current gross charges —2.96 Discounts, Pro Fees_ (M F M onthly C halpe 0. Fede Universal s F und D Fed Teleco Rel ay Service -.4 —o -py �D $3.40 BI BA YH #26Y5 141 Owest Total Advantage Current gross charges 33 -26 Discounts, Promotions Fees_ 0. 29 Governm P ons and Taxes— 0.09 Sta and Local Taxes 0. Other Fees Monthl Charges 4.90 Federal Universal Service Fund 4 49 Fed Tel Relay Service 0.40 IN USF Surcharge 0.01 $37.87 JO 434 t6 142107379 Q T Ad Currant gross charges_ 6.98 Discounts, Promotions Fees —.0.09 Gove rnment Fee and Taxes 0.11 Stain and Local Taxes 0.1 Other Fees a Mon thly Ch slges 0, 65 Federal Universal Service Fund 0.77 Fed Tatecom Relay Service 0.07 IN VSF Surchar S'+.es i I I i Invoic 11 GROUP IT Services Invoice Date: 3 -26 -10 Invoice Number 0310 -2695 Company: Shiel Sexton Company, Inc. Project: Project Number: Carmel -PAC Summary Description Wireless Phone, Equipment, IT Service Amount 1,287.86 Total Contact Tim Malarney with questions (317) 423 -6111 Shiel Sexton IT Group 902 N. Capitol Ave Indianapolis, IN 46204 PROGRAM: JU3611 SPEEDWAY SUPERAMERICA REPORT: 00-27642 PAGE DATE PREPARED: 0510812010 TIME PREPARED; 22t58:51.9 SUPERFLEET REPORT TYPE: MONTHLY 2010/03/08 COMPANY NAME: SHIEL SEXTON INC ACCOUNT: 100 0194 009 INQUIRIES? PHONE: 1-800-428-016 E-MAIL: SSACREDITCARDDSSALLC.COM FAX: 1-937-864-3091 rED.ID: 31-1551430 7 TIME/ FUEL OIL MERCHANDISE SALES TOTAL DRIVER CHG TO ID STORE DATE TICKET PROD GALLONS $A;AL AMOUNT QUARTS AMOUNT AMOUNT TAX AMOUNT CLEM COOK 2560 001302 02 5;48:03 EUN 15.4 2.566 39.51 0 .00 .00 .00 39.51 CLEM COOK 25b0 000393 02 18;32;45 EUN 29.1 2.524 so.qB -D .00 .00 .00 50.46 CLEM COOK 25bo ooblko 02-16-2010 10-.04:58 E UN 3.9 2.400 9.30 .0 .00 .00 .00 9.30 CLEM COOK 25b0 001302 02-21-2010 12i30:5b EUN 20.6 2.524 52.49 a .00 no .00 52.49 CLEM COOK 2560 001302 03 5:51:39 EUN 18.9 2.55 47.96 a .00 co .00 47.98 TOTAL CHG TO 11) 2569 79.2 2.529 200.32 .0 .00 .00 .00 200.52 TOTAL DRIVER CLEM COOK 79.2 2. 200.32 .0 .00 .00 .00 200.32 CRAIG KOCH 3471 005120 02-15 -2010 11:26:05 EUN 13.5 2.401 .32.42 .0 .00 00 .00 32.42 TOTAL CHG TO ID 3471 13.5 2.401 32.42 .0 .00 .00 .30 32.42 CRAIG KOCH 3007 005525 02-18-2010 8:46:20 EUN 13.8 2.596 35.85 -0 '00 .00 .00 35.85 CRAIG KOCH 3*97 042432 02-23-2010 20:08;01 UNL 11.4 2.662 30.56 .0 .00 .00 .00 30 -58 TOTAL CHG TO ID 3607 25.2 2.b3o 66. .0 .00 .00 Do 6b.43 TOTAL DRIVER CRAIG KOCH 38.7 2.55 98.85 .0 .00 .00 98-65 BAN SMITH 3677 071253 02-12-201D 9:05;15 UNL 17.9 2.591 4 -,37 .0 uo .00 .00 4b.37 DAN SMITH 307 001040 02-17-2010 18:21:3 UNL 17.6 2-620 4u.12 .0 .00 Do .00 46.12 DAN SM11H 3*77 001040 02 21:28:43 UNL 13.4 2 .713 3o. 3o D .00 .00 .00 3b.3b TOTAL CHG TO 10 3*77 48.9 2.b34 126.85 .00 .00 .00 128.85 DAN SMITH 3733 005517 03-02-20I0 9:06:05 EUN 18-3 2. 536 Cb. ',1 .0 .00 .DO .00 46.41 TOTAL CHG TO ID 5733 18.3 2.636 4b -0 -00 Do .00 46.41 TOTAL DRIVER DAN SMITH 67 2.008 175, .0 .00 00 .00 175.26 DARYL COLEMAN 3b4C 062968 U2-08-2010 15:30:03 UNL 11.5 2 30.02 .0 00 .00 .00 30.02 DARYL COLEMAN 3b40 Dob093 02 8 :49:13 EUM 13.b 2.451 33.34 .0 .00 .00 .00 35.34 DARYL COLEMAN 3640 007774 02-26-20143 16. EUN lt. b 2,658 44.12 .0 .00 .00 .00 44.12 TOTAL CHG TO ID 3040 41-7 2.677 107.46 .0 .00 .00 107.48 DARYL COLEMAN 3718 007887 03-03-2010 I4:11:21 EUN 12.7 2.550 32.46 '00 OD 00 52.4b TOTAL CHU TO ID 3718 12.7 2.555 32.46 .0 .00 .00 .00 32.4b TOTAL DRIVER DARYL COLEMAN 54.4 2.572 134.94 .0 .00 .00 .00 139.94 I DAVE BURCHARD 2t,95 00132t. 02-12-2010 17:18:15 EUN 18.7 2 523 47. .0 .00 .00 ou 47.18 DAVE BURCHARD 2695 043364 03-03-2010 17:53:24 UNL 19.0 2.707 51.43 .0 .00 ou .00 51.43 TOTAL CHG TO ID 2695 37.7 2.615 98.61 .0 OD .00 .00 48.61 TOTAL DRIVER DAVE BURCHARD 37.7 2,613 l ro ipmf .0 .00 98.61 �-.tl%6,� DAVE FARRIS 35 oob3b8 02-09-2010 16;GD:01. EON 13. 2.566 34.90 .0 .00 .00 .00 34.90 DAVE FARRIS 3573 005514 02-21-2010 17:0b;22 EUN Ia.& 2.555 41,20 '00 .00 .00 47.26 DAVE FARRIS 3573 001302 02 25 -2010 5;20:46 EUN 15.4 2.622 40.38 .0 OD .00 .00 40.38 PROGRAM: JD3611 SPEEDWAY SUPERAMERICA REPORT: DD -27b42 PAGE 5 DATE PREPARED: 03/06/2010 TIME PREPARED: 22 :58:51.9 SUPERFLEET REPORT TYPE: MONTHLY 2010/03/ COMPANY NAME: SKIEL SEXTON INC ACCOUNY: 100 0194 009 INQUIRIES? PHONE; 1- 800 428 -4016 E -MAIL: SSACREDITCARDdSSALLC.COM FAX: 1- 937 864-3091 FED.IO: 31- 1551430 TIME FUEL z AZxz *zrz* z zz *a OIL *AZ *A*! MERCHANDISE SALES TOTAL DRIVER CHG TO ID STORE DATE TICKET PROD GALLONS $/GAL AMOUNT QUARTS AMOUNT AMOUNT TAX AMOUNT DAVE FARRIS 3573 001302 03 -04 -2010 5:28:08 EUN 13.8 2.488 34.34 D .00 .00 .00 34.34 DAVE FARRIS 3573 005514 03 -Ob -2010 10:51:35 EUN 12.2 2,655 32.39 .0 .00 .00 .00 32.39 TOTAL CHG TO ID 3573 73.5 2.575 ld9.27 .0 .00 .00 ,00 189.27 TOTAL DRIVER DAVE FARRIS 73.5 2.575 189.27 .0 .00 .00 .00 189.27 DAVE LAWRENCE 2095 008619 02 -09 -2010 18:24:07 UNL I2.7 2.588 32.87 .0 .00 .00 .00 32.87 DAVE LAWRENCE 2645 008619 02 -12 -2010 19:20:34 UNL 14.0 2.574 36.03 .0 .00 .00 .00 36.03 DAVE LAWRENCE 2695 068619 02 -15 -2010 17:44:08 UNL 9.8 2.563 25.12 .0 .00 .00 .00 25.12 DAVE LAWRENCE 2695 II3451 02 -18 -2010 17:22:10 UNL 15.1 2. tot, 39.35 .0 .00 .00 .00 39.35 DAVE LAWRENCE 2695 113951 02 -25 -2010 17:19:56 UNL 15.4 2.705 41.b2 .0 .00 .00 0D 41.62 DAVE LAWRENCE 2095 005387 03 01 2010 7:0b:09 EUN 15.1 2.548 58.48 .0 .00 .00 .00 38.48 DAVE LAWRENCE 2b9S 113951 03 -04 -2910 18:05:18 UNL 14.3 2.099 38.60 .0 ,00 .00 .0O 38.60 DAVE LAWRENCL 2695 120754 03 -07 -2010 19:17:16 UNL 11.2 2.692 30.15 .0 .00 .00 .00 30.15 TOTAL CHG fO ID .2695 107.b 2.622 282.22 .0 00 .00 .00 282.22 TOTAL DRIVER DAVE LAHRENCk 107.6 2.622 %2821:22;; .0 .00 .00 .00 282.22 DAVID LAND 2535905 003303 02 14 2010 14:34:55 EUN 24.0 2,467 60.70 .0 .00 .00 .00 b0.70 TOTAL CHG TO ID 2535905 24.0 2.467 00.70 .0 .00 .00 .00 60.70 DAVID LAND 3700900 003303 03 02 2010 19:33:44 EUN 23.2 2.534 58.78 .0 .00 .00 .00 58.78 TOTAL CHG TO ID 3700900 23.2 2.533 58.78 .0 .00 .00 .00 58.78 TOTAL DRIVER DAVID LAND 47.8 2.499 119.48 .0 .00 .00 .00 119.48 DENNIS COMBS 3471 008207 02.11-2010 6:54:22 EUN 4.9 2.449 12.00 .0 .00 .00 .00 12.00 DENNIS COMBS 3471 109884 02 -11 -2010 17:38:43 UNL 12,0 2.500 30.00 .0 .00 .00 0o 30,00 DENNIS COMBS 3471 008207 02 -1b -2010 6:44:30 EUN 9.1 2.3b4 21.51 .0 DO .00 .00 21.51 DENNIS COMBS 3 008267 02 -1b -2010 6:45:49 EUN 21.9 2.364 51.78 .0 .00 .00 .00 51.78 DENNIS COMBS 3471 159491 02 -18 -2010 12:57:55 UNL 11.9 2.605 31.00 .0 .00 .00 .00 31,00 DENNIS COMBS 3471 159491 02 -18 -2010 12:58:39 UNL 17.1 2.598 44.43 ,0 .00 .00 00 44,43 DENNIS COMBS 3471 008267 02 -22 -2010 7:06:34 EUN 8.3 2.530 21.00 .0 .00 .00 .00 21.00 DENNIS COMBS 3471 159491 02 -22 -2010 15:07:30 UNL 9.4 2.b6U 25.00 .0 .00 .00 .00 25.00 DENNIS COMBS 3471 0082b7 03 -04 -2010 6;11:14 EUN 8.3 2.530 21.00 .0 .DO .00 00 21.00 DENNIS COMBS 3471 159491 03 -04 -2010 14:54:33 uHL 8.6 2.557 22.50 .0 ,00 .00 .90 22,50 TOTAL CHG 70 ID 3471 111.7 2,508 280.2'2 p .00 .00 .00 280.22 TOTAL DRIVER DENNIS COMBS 111.7 2.508 280,22 .0 .00 .00 .00 280,22 DENNIS WHITE 3553 006195 02- 09-2010 4:48:33 EUN 26.3 2.563 67,41 .0 .DO 00 .00 67.41 DENNIS WHITE 3553 007329 02 -20 -2010 18:19 :16 EUN 2211 2.599 57.44 .0 .00 .00 .00 57.44 DENNIS WHITE 3553 00b195 03-04-2010 0:16 :57 EUN 21.0 2.530 53.12 ,0 .00 .00 00 53.12 TOTAL CHG TO ID 3553 69.4 2.5b4 177,97 0 .00 .00 .00 177.97 TOTAL DRIVER DENNIS WHITE 69.4 2.564 177.97 .0 ,00 .00 .00 177.97 PROGRAM: JD3oll SPEEDWAY SUPERAMERICA REPORT: OD -27642 PAGE 15 DATE PREPARED: 03/08/2010 TIME PREPARED; 22:58:51.9 SUPERFLEET REPORT TYPE: MONTHLY 2DIO/03/08 COMPANY NAME; SHIEL SEXTON INC ACCOUNT: 100 0194 009 INQUIRIES? PHONE: 1- 800-428-4016 E -MAIL: SSACREDITCARD4SSALLC.COM FAX: I- 937 864-3091 FED.10: 31- 1551430 TIHE1 *x *x FUEL R OIL x* MERCHANDISE SALES TOTAL DRIVER CHG TO ID STORE DATE TICKET PROD GALLONS S /GAL AMOUNT QUARTS AMOUNT AMOUNT TAX AMOUNT TOTAL DRIVER MATT MARVIN 261.5 2.634 690,16 0 .00 .00 .00 690. .16 I MIKE ANDERSON 2045 001316 D2-13-2010 9:04:54 EON 17.1 582 44.16 .0 .00 .00 .00 44.1b MIKE ANDERSON 2695 001316 02 -19 -2010 18:29:48 EUN 15.9 2.599 41.32 .0 .00 .00 .00 41.32 MIKE ANDERSON 2645 0054(.8 02 -2b -2010 6:16:12 EUN 14.3 2.692 38.50 .0 .00 .00 .00 38.50 MIKE ANDERSON 2695 005468 03 -05 -2010 6:12:27 EUN 11.0 2.693 29.62 .0 .00 .00 .00 29,62 TOTAL CHG TO ID 2695 58.3 2.634 153.60 .0 .00 .00 .00 153.60 TOTAL .DRIVER MIKE ANDERSON 56.3 2.634 153''60 0 DO .00 .00 153.60 HIKE BAUGH 1205 005U14 02-09 -2010 10:51:25 EUN 9.4 2.579 24.24 .0 .00 .00 .00 24.24 MIKE BAUGH 1205 005016 02 -11 -2010 12:22:09 EUN 11.3 21557 28.89 .0 .00 ,00 00 28.89 MIKE BAUGH 1205 003304 02-13 -2010 9:03.39 FUN 11.3 2,519 2B -47 .0 .00 .00 .00 28.47 MIKE BAUGH 1205 U05014 02 -16 -2010 5:24:54 EUN 14.7 2.593 38.12 .0 .00 .00 .00 38.12 MIKE BAUGH 1205 DoSO16 02-19 -2010 12:30:07 EUN 2019 2.574 53.79 .0 .00 -00 .00 53.79 MIKE BAUGH 1205 OO5OI4 02 -24 -2010 10:21:17 EUN 17 -7 2.bb9 47. Z4 .0 .00 .00 .00 47.24 MIKE BAUGH 1205 007887 03-04-2010 7:2b:24 EUN 22.b 2.554 57.73 .0 .00 .00 .00 57 -73 MIKE BAUGH 1205 001331 03 -06 -2010 0:27:19 EUN 10.9 2.088 24.30 .0 .6D DD Oa 29.30 TOTAL CHG TO ID 1205 118.8 2.590 307.78 .0 .00 -00 .DO 307.78 MIKE BAUGH 1250 005014 03- 02-2010 8:01:03 EUN 12.0 2.588 31.05 .0 DO .DO .00 31,.05 TOTAL CHG TO ID 1250 12.0 2.587 32.05 .0 .00 .00 .00 31.05 TOTAL DRIVER MIKE BAUGH 130.6 2.590 338.83 .0 .DO .00 .00 338.83 MIKE BLEOSOE 3180 005005 02-10 -2010 11:19:49 EUN 18.8 2.580 48.50 .0 .00 .00 .00 48,50 MIKE BLEDSOE 3180 005005 02-12 -2010 15:38:42 EUN 15.9 2.554 40,01 .0 .00 .00 .00 40.61 MIKE BLEDSOE 3180 005005 02 -12 -2010 15 ;42:38 DISL 9.8 2.755 27.00 .0 0o .00 .00 27.00 MIKE BLEDSOE 3160 005005 02 -17-2010 14:09 ;04 DISL 4.7 2.769 2b.8b .O .OD .00 .00 26.8o MIKE BLEDSOE 5180 005005 02 -18 -2010 11:2b:47 DISL 9.0 2,751 24.76 .0 .00 .00 .00 24.76 MIKE BLEDSOE 3180 OOSODS 02 -19 2010 12:20:15 DISL 9.8 2.772 '7.17 D ,00 .00 .00 27.17 MIKE BLEDSOE 3180 005005 02-19-20I0 12 :57:10 DISL 918 2.709 27.14 .0 .00 .00 .00 27.14 MIKE BLEDSOE 3180 102947 02-19 -2010 13:39:17 UNL 18.9 2.594 44.02 .0 .00 -00 .00 49.02 MIKE BLEDSOE 31 H0 106470 02 -24 2010 13:34:12 UNL 21.2 2.671 56.63 .0 .00 -DO .00 56.63 MIKE BLEDSOE 3180 Oo50U3 02-26-2010 15:18:48 UNL 1512 2 -659 40.42 .9 .00 .00 .00 40.4 MIKE BLEDSOE 3160 009209 03 -92 -2010 16:29:43 UNL 20.8 2.571 53.48 .0 .00 .00 .00 53.48 TOTAL CMG TO ID 3180 158.9 2.053 421.59 .0 .00 .00 .OD 421.59 TOTAL DRIVER MIKE BLEDSOE 158.9 2.653 421.59 .0 .00 .00 DO 421.59 MIKE GREEN 3285 095525 02-17 -2010 6:41:54 EUN 12.0 2.439 29.27 _0 .00 .60 .00 29.27 TOTAL CHG TO ID 3285 12.0 2.439 29.27 .0 .00 -00 .00 29.27 MIKE GREEN 3343 006143 02 -11 -2010 18:43:47 EUN 11.9 2.517 29.45 .0 .00 .00 .00 29.95 111KE GREEN 3343 000143 02 -23 -2010 7:21:52 EUN 11.7 2.702 1 1.01 .0 .00 .OD .60 31.bl MIKE GREEN 3343 006143 03 01 -2019 16141:20 FUN 12.3 2.563 31.77 .0 .00 .00 .60 31.77 TOTAL CHG TO ID 3345 35.9 2.599 93.33 .9 .00 .00 .00 93.33 W, PROGRAM: JD3611 SPEEDWAY SUPERAMERICA REPORT; OD -27642 PAGE 16 DATE PREPARED: 03/08/2010 TIME PREPARED: 22:58:51.9 SUPERFLEET REPORT TYPE: MONTHLY 2010/03/08 COMPANY NAME: SNIEL SEXTON INC ACCOUNT: 100 0194 009 INQUIRIES? PHONE: 1- 800 428 -4010 E -NAIL: 55ACREDITCAROaSSALLC.00M FAX: 1-937-864 -3091 FED.ID: 31- 1551430 TIME/ FUEL +RRxM+ttrtcK■ K■rnrk OIL itA-** %A MERCHANDISE SALES TOTAL DRIVER CHG TO ID STORE DATE TICKET PROD GALLONS ',/GAL AMOUNT QUARTS AMOUNT AMOUNT TAX AMOUNT MIKE GREEN 3700 005033 03 -05 -2010 11:59110 EUN 12.0 2.693 32 -34 .0 .00 .00 .00 32.32 TOTAL CHG TO ID 3700 12.0 2.093 32.32 .0 .00 .00 .00 32.32 TOTAL DRIVER MIKE GREEN 59.9 2_586 154.92 .0 .00 00 .00 159.92 MIKE KARPINSKI 3416 005468 02 -11 -2010 17:01:20 EUN 20 -0 2.575 51.50 .0 .00 .00 .00 51.50 MIKE KARPINSKI 3416 005468 02 -17 -2010 19:45:24 EUN 21.5 2.593 55.76 .0 .00 .00 .00 55.76 MIKE KARPINSKI 3416 OObOb6 02 22 2DI9 6 :55:47 £UN 20,1 2.525 50.75 .0 .00 .00 .00 50.75 HIKE KARPINSKI 3410 OUbOb6 02- 24-2010 6,58:44 EUN 19.5 2.o67 52.00 .0 •00 .00 .00 52.00 MIKE KARPINSKI 3410 213 02 -Zb -2010 16:38:06 UNL 17 -5 2.700 47,25 .0 .00 .00 .00 47.25 MIKE KARPINSKI 3410 000060 03- 02-2010 7:02:U8 EUN 17.0 2.588 44.00 .0 .00 .00 .00 44.00 MIKE KARPINSKI 3410 042432 03 -04 -2010 8:00:06 UNL 18.4 2.582 47.50 .0 .00 .00 .00 47.50 TOTAL CHG 1'0 IO 341b 134.0 2.602 346.76 .0 .00 .00 .90 346.76 TOTAL DRIVER MIKE KARPINSKI 134.0 2.602 348.76 .0 .00 .00 .00 348,76 MIKE PATARINO :114 110072 UL I5 -2010 7:41:03 UNL 1b.7 2.392 39.95 .0 .00 .00 .00 39.95 MIKE PATARINO 2114 110072 02 -22 -2010 7;22:22 UNL 16.7 2.521 42.10 .0 .00 .00 .00 42.10 MIKE PATARINO ::114 110072 02 -2b -2019 b:L6:57 UNL 14.2 2.57o 3o. 4c) .0 .00 .00 .00 36.49 MIKE PATARINO 2114 110072 03- 04-2010 9:51:39 UNL 15.2 2.707 41.14 .0 .00 .00 .00 41.14 TOTAL CHG TO IO 2114 62.8 2,542 159.08 -0 .00 .00 .00 159.68 TOTAL DRIVER MIKE PATARINO 62.8 2.542 1 59.b8 .0 .00 .00 .00 159.68 MIKE STROLE 2695 001040 02 -09 -2010 7:06:35 DISL 27.5 2.909 80 00 .0 .00 .00 .00 80,00 TOTAL CHG 'TO ID 2695 27.5 2.909 60,4 0( t: 0 .00 .00 .00 60.00 MIKE STROLE 3709 000120 02 -19 -2010 9:09:06 DISL 19.3 2.042 51.00 .0 .00 .00 .00 51.00 TOTAL CHG TO IU 3799 19.3 2.642 51.00 .D .90 .00 .00 51.00 MIKE STROLE 3072500 0060bb 03-01-2010 16:49 :15 DISL 41.7 2.902 121.00 -0 .00 .00 .00 121.00 TOTAL CHG TO 10 3072500 41.7 2.901 121.00 .0 .00 .00 DO 121.00 TOTAL DRIVER MIKE STROLE 88.5 2.847 252.00 D 00 .00 .00 252.00 NICK BURNETT' 3,,74 073213 02-22 -2010 14:35:44 DISL 8.0 2.920 23.3o 9 00 .00 .00 23.36 TOTAL CHG TO ID 3074 8.0 2.920 23.3b .0 ,00 .00 .00 23.36 TOTAL DRIVER NICK BURNETT 8.0 2.920 23.36 .0 .00 .00 -00 23.36 OLIVER HASTE 3b84 007675 02 -08 -2010 10:47:47 EUN 26.o 2.p63 70.84 .0 .00 .00 00 70.84 OLIVER HASTE 3684 162875 02 -11 -2010 7:34:31 UNL 22.2 2.477 55.00 .0 .00 .00 .00 55.00 OLIVER HASTE 3b84 006384 D2 12 2010 10:15:48 EUN 20.1 2.530 50.86 .0 .00 .00 .00 50.86 OLIVER HASTE 3684 D07b75 02 15 2010 17:07:91 EUN 18.9 2.593 49.00 .0 ,00 .00 .00 99,00 OLIVER HASTE 3b64 006384 02 1b -2010 18:47:40 EUN 24.5 2.480- 00.75 -0 .00 00 .00 60.75 OLIVER HASTE 3664 074435 02 -18 -2010 1.7 :39:37 UHL 22.9 2 .598 59.50 .0 .00 .00 DO 59.50 PROGRAM: J03bll SPEEDWAY SUPERAMERICA REPORT: OD-27b42 PAGE 20 DATE PREPARED: 03/08/20t0 TIME PREPARED: 22:58:51.9 SUPERFLEET REPORT TYPE: MONTHLY 2010/03/08 COMPANY NAME: SHIEL SEXTON INC ACCOUNT; 100 0194 009 INQUIRIES? PHONE: 1 -800- 428 4010 E SSACREDITCARDaS5ALLC.CON FAX: 1 937 864 FED.IO: 31.- 1551430 TIME) FUEL ft*xk OIL *M* MERCHANDISE SALES TOTAL DRIVER COG TO ID STORE DATE TICKET PROD GALLONS 6 /GAL AMOUNT QUARTS AMOUNT AMOUNT TAX AMOUNT TIM BROGAN 3072905 00132b 02 26 2010 7:03:59 EUN 20,7 2,643 54,72 .0 .00 DO DO 54172 TIM BROGAN 3072905 a0132b 03 7:15:17 EUN w1,4 2.703 57.84 .0 .00 .00 .00 57.84 TOTAL COG TO ID 3072905 42.1 2.673 112.50 .0 DO .00 DO 112.56 TIM BROGAN 3072915 OOb120 02-22 9:50:34 EUN 22.b 2.700 1)1.01 .0 .0o .00 .00 61.01 TOTAL CHG TO ID 3072415 22.6 2.699 61.01 .0 .00 .00 .00 61.01 TOTAL DRIVER TIM BROGAN 64.7 2.682 173.57 .0 .00 .00 .00 173.57 TIM ISLE 9999 007329 9'2-12-2010 20:15 EUN* 20.5 2- 97 53.23 .0 .00 .00 .00 53.23 TIM ISLE 9999 0053a7 02- 23-2010 7:51:12 EUNt 21.4 2.804 00.00 .0 .00 .00 .00 b0.00 TIM ISLE 9999 001316 02- 28-2010 18;51:52 EUNr 15.9 2.773 44.99 .0 .00 .00 .00 44.09 TOTAL CHG To ID 9999 57.8 2,721 157,32 .0 .00 .00 .00 157.32 TOTAL DRIVER TIM ISLE 57.8 2.721 157.32 .0 .00 .00 .00 157.32 TODD ANDERSON 3593 006105 02 -10- ^010 16:37:56 EUN 36.4 2.500 41.00 0 .00 .00 .00 41.00 TODD ANDERSON 3593 004018 02 -16 -2010 7:31:12 EUN 15.8 2.408 39.00 .0 .00 .00 .00 39.1)0 TODD ANDERSON 3593 005525 02 -19 -2010 17:35:3b EUN 17.8 2.584 4b. Do .0 .00 .00 OQ 46.90 TODD ANDERSON 3593 005525 02- 24-2010 7:53 :47 EUN 16.3 2.6 44.00 .0 .00 .00 .00 44.DO TODD ANDERSON 3593 004018 03 -02 -2010 6:47:41 EUN 17.3 2.601 45.00 .0 .00 .00 .00 46.00 TOTAL CHG TO ID 3593 63.6 2.571 215.00 .0 .00 .00 .00 215.00 TOTAL DRIVER 1 ANDERSON 83.b 2.571 215.01) .0 .00 .00 .ca 215.00 TOM SCHEELE 2506 006120 03 -04 -2010 L5:9Oc06 EUN 26.3 2.b99 70,48 .0 .00 .30 .00 70.98 TOTAL CHG 10 10 2500 2b.3 2.698 70.48 .0 .00 .00 .Do 70.95 TOM SCHEELE 2500 006120 02-12-2010 10:01:43 EUN 28.6 2.395 o8.51 .0 .00 .00 .00 68.51 TOM SCHEELE 2500 006120 02 -22 -2019 11:20:58 EUN 28.6 2.690 77.10 .0 .00 .00 .00 77.10 TOM SCHEELE 25bO 003993 03 06 2010 14:41:07 EUN 18.0 2.692 48.45 .0 .00 .00 .00 48.45 TOTAL CHG TO 10 2500 75.2 2.580 194.(16 .0 .00 .00 ,De 194.06 TOTAL DRIVER TOM SCHEELE 101.5 2.611 265.04 .0 .DO 00 .00 265.04 TOMMY HUTSELL 3blo 001316 02 27 7:39:34 EUN 19.4 2.674 51.98 .0 .00 .00 .00 51.98 TOTAL CHG TO 10 3010 19.4 2.o79 51.96 .0 .00 .00 .00 51.96 TOMMY OUTSELL 3036 005528 02-09 -2010 17 :47;35 EUN 1b.4 2.588 42.44 .0 .00 .00 .00 42.44 TOMMY OUTSELL 3030 005528 02 -15 2010 18:34:02 EUN 18.4 2.435 44.80 0 .00 00 .00 44.80 TOTAL CHG TO IO 3636 34.8 2.506 87.24 .0 .00 .00 .00 87.24 TOTAL DRIVER TOf1MY OUTSELL $4.2 2.568 139.22 .0 .Do .00 .co 139.22 TONY EISENHUI 2695 113951 0, 8:13:31 UNL 22.1 2.Sbd So -76 .0 .00 ,U1) .00 56.76 TONY EISENMUT 2o95 006093 02 -20 -2010 16:47 :34 EUN 24.0 2.551 o2.70 -0 .00 .00 .00 62.76 TONY EISENHUT 2695 113951 02 7:50:10 UNL 23.5 2.700 03.59 .0 .00 .Do .00 03.59 PROGRAM: JD3oll SPEEDWAY SUPERAMERICA REPORT: OD -27b42 PAGE 21 DATE PREPARED: 03/08/2010 TIME PREPARED: 22:58:51.9 SUPERPREET REPORT TYPE: MONTHLY ZQI0 /03/08 COMPANY NAME: SHIEL SEXTON INC ACCOUNT: 100 0194 009 INQUIRIES? PHONE: 1- 800 428 -4016 E -MAIL: SSACREDITCARDOSSALLC.COM FAX: 1- 937 -864 -3091 FED.IO: 31- 1551430 TIME/ x *xxx* *xx*x FUEL OIL *x MERCHANDISE SALES TOTAL DRIVER CHG TO ID STORE DATE TICKET PROD GALLONS 51GAL AMOUNT QUART'S AMOUNT AMOUNT TAX AMOUNT TONY EISENHUT 2695 065979 03-03 7:13:18 UNL 26.5 2.554 b7.68 .0 .DO .00 .00 67.68 TOTAL CHG TO ID 2695 96.7 2.593 250.79 .0 .00 .00 .00 250,79 TOTAL DRIVER TONY EISENHUT 9o.7 2.59325a v? .0 .00 DO 00 250.79 -------`""'-1_.-.a`--------------------------------------------- TONY JULIAN 3242 606066 02 -13 -2010 12:56:29 EUNP 22.3 2.735 61.00 .0 .00 .00 .06 61.00 TONY JULIAN 3242 046120 02 -22 -2010 23:21:12 EUNP 22.4 2.902 05.00 .0 .00 .00 .00 65.00 TONY JULIAN 3242 006124 03 -01 -2010 8:30;16 EUNP 22.9 2.730 02.51 .0 .00 .00 ,00 62,51 TOTAL CHG TO ID 3242 67.6 2.788 188.51 .0 .00 .00 pd 188.51 TOTAL DRIVER TONY JULIAN 67.6 2.788 188.51 .0 .00 .00 .00 188.51 TRAVIS MILLER 3593 007155 02 -15 -2010 17:10:38 DISL 36.3 2.896 105,14 .0 .00 .00 .00 105.14 TRAVIS MILLER 3593 007155 02-15 -2010 17:18:50 EUM 9.2 2.441 22.4b .0 ,00 .00 .00 22.46 TRAVIS MILLER 3543 007155 02 -18 -2010 16:50:32 DISL 38.4 2.898 111.30 .0 .00 .00 .00 1,11.30 TRAVIS MILLER 3593 007155 02-23 2010 17;19:42 DISL 37.6 2.899 109.00 .0 .00 -QO .00 109.00 TOTAL CHG TO ID 3593 121.5 2.863 347.90 .0 .00 .00 .00 347,90 TRAVIS MILLER 3607 007155 02 -08 -2010 16:41:49 DISL 39.3 2.900 113.96 .0 .00 .Oo .00 113.96 TOTAL CHG TO TO 3607 39 -3 2.899 113.9b .0 .00 .00 .00 113.90 TRAVIS MILLER 3697 007155 02- 26-2010 16:38:48 DISL 40.1 2.697 116.17 .0 .00 .00 .00 116.17 TRAVIS MILLER 3697 007155 03-02 -2010 16:21:05 DISL 24.$ 2.896 70.38 .0 .00 .00 .00 70.38 TRAVIS MILLER 3697 007155 03 -04 -2010 17:31:13 DISL 31.7 2.896 91.81 .0 .06 .00 .00 91141 TOTAL CHG TO 11) 3697 96.1 2.896 278.36 .O .00 .00 .00 276.3b TOTAL DRIVER TRAVIS MILLER 256.9 2.881 740.22 .0 .00 .oa .00 740.22 WARREN BREWER 2695 QObO95 02 -11 -2010 8:06:10 EUN+ 16.9 2.657 44,91 .0 .00 .00 OD 44.91 WARREN BREWER 2695 113451 02 -17 -2010 15:56:59 UHL 16.4 2,571 42.1b .0 .00 .00 .00 42.16 WARREN BREWER 2695 113951.02 25-2010 7:24:18 UHL 17.1 2.o75 45.75 ,0 .00 .00 .00 45.75 WARREN BREWER 2695 113951 03- 04-2010 11:52:07 UHL 16.8 2.700 45.30 a .00 .00 .00 45.36 TOTAL CHG TO ID 2695 67,2 2.651 178 -18 .0 -00 .40 -00 178.18 TOTAL DRIVER WARREN BREWER 67.2 2.o51 r .o .ao .ao .4a 178.16 WARREN TETRICK 9999 066366 02 -09 -2016 3:28:35 EUN 27,6 2.579 71.19 .0 00 .00 .00 71.19 WARREN TETRICK 9999 115873 02 -12 -2010 13:25:41 UHL 28.5 2.514 71,o5 .0 .00 .00 .00 71.65 WARREN TETRICK 9999 006368 02- 18-2010 6:27 :44 EUN 27.8 2.582 71.77 .4 .06 .00 .00 71.77 WARREN TETRICK 9999 111641 02 -24 -2610 6:13:44 UNL 26.5 2.706 77.12 .0 UO Do .00 77.12 WARREN TETRICK 9999 115873 03- 01-2010 16:44:58 UHL 26.9 L.577 69.32 .0 -00 .00 .00 69.32 TOTAL CMG TO ID 9999 139.3 2.591 361,05 .0 .00 .DO .00 361.05 TOTAL DRIVER WARREN TETRICK 139.3 2.591 301.05 .0 .00 .00 .00 361.05 Pago 307 r r 4 Vi I MARCH 15. 2010 MARCH 15, 2010 Account Number: 9463 Account Number: 9453 Invoice Number: 03452618 invoice Number: 03452818 A. BALANCE DUE, PAYMENTS, ADJUSTMENTS EANTERNET DATA Belance Due From a Previous Stalemeril on 10: 95921 Payments Location N5 S 11 ON Thank you Pa Receitvik (P,53120) Location Addrts NQ 28271 Total PAYMent Type of Servic EM Ch;.iqi Fro M T Amoun jjoaLAdhm1mwnft $0.00 IMemel Transpornt I ;�s Tim X.IA!, AMOQNT 0 nlernel Mbps 03115r10.04l16110 1 $221.0 Memel T on T1 03116110 04114!10 2 '276 0 Inter ess 10 Mbps 03109110 03114110 1 12 .40 It. lAcces 03/15110-04114110 1 Do )nlemel Access 3 Mlem 0&15116,04114M I DO B-IINTEGRATED SERVICES BUNQ�F L 10: 93S7 i 5 TOTAL Location fD: 95121 Location Nome: $NIEL SEXTON L 777 3ROAA §N, CARMEL, IN, 46032 T of Sorvic E0 Op �10 M 120 quartil Amou Voice 71 LoClltlon'Name� S Flat 2 wa y 36 D3/15110.04/14110 1 HIE L SEXTQU s5 L&"Ilgn dbrowgUNCAMT. LIS, IN, 462 FLEXCALL 5K FIM 0- 10K TIER 02!1 5110 03114110 1 0.00 TOTALLoaallon 51110 wbi TYPa of SQFViC PON Charge From Tn- quR Amount ONE PORT 10alla e 10a1 Mit6n0- 04114110 1 TOTAL Champs Without Tax For $g $511.0 EnterpriVNCAN lAh 10Mbp 031151-10.04114110 ll S60.00/ Inteme T reportlOOMps 03115110. 1 3 TD0.0if I Taxes, Few Surcharges 1n1cmeZrarisporl 10DMbps 0305110- D4114(10 i ;S2 0 Fedval Universal Servical'und(USF) Surcharge 5112.42 IntleTclAccess 2 M Ws 011SID. 04MVI-3 1 0 DEAF Ut Surcharge $0-69 -If07ematAccess 25 MIpps 01151if), D01013 I 31.A 0 IN State Utilit Receipts Reirnburselnenl Surcharge: $602 TOTAL Location 10: 30975 State Sales Tax 530.52 State Un!veisaf Service Fund (LISF)SU(charge. 51,72 2911 Surcharge 546,00 Location ID; 61 n03 TOTAL Tax §ogfiun 2717 LocaLlon 143ine: SHIEL TOTAL CHARGES FOR AECTION 7 Locallon AddFes5'44MENT AVE AN OLIS.IN.462DZ INDIAN PON Ch arge Frorp. b Qumt Typi: of Serld� DT15M 041'.4)10 L Am o u nt 0. CALL MANAGEMENT <Tag S: 0 TOTAL Location il): 66603 1, Location 10: 9397 .01 Lcaellon Name: SHIEL SEXTON 6' Locatim Address: 777 3RO AYE 3W. CARMEL 4 6072 W50 T of Service PON Chame From ST uantity Amount Restfiction 03115!10. 04114110 1 $0.00 Locall[gri Address: 2w iNG ST. INDIANAPOLIS, IN 4620 Call 910Cd ing 03! 15110 04114110 ndividual T I iO ephw e Number 01115110 G 44x74110 TOTAL Location ID: 93972 $7.35 �VE T a l I c S250. 49 $7.35 Charge From To yanti Q Fcllaq�& SNLAN In. 1 Wbqs 031 15110.04!1411 0 1 v% 0 00 TOTAL Chmqinifflhout Tax For Section D 4 TOTAL Location 10; 66504 .1 Taxes, Fees. Surchara Federal Excise Tax S022 Wq- U iN State Utility Receipts Reirnbumernent Stjtnharga $0,10 Location ID; 9337 L �v 1 2. C St Universal Service Fund (USF) Surcharge M03 Lgaelion Name: AHIEL SEXTON TOTAL Tax For Section 0 v Location Address: 777 3RD AVE SW. CARMEL, IN, M TOTAL CHARGES FOR SEcTI bmt oE3 srvlce Pal Chairea From To Duantl A internal Transport 10 Niteps 07115110 04!14110 1 S250.00 InterrietAGcoss 6 Wbps 0115110-04114(110 1 $795 OD TOTAL 1-mation 11): 93972 4 I L I p-i vrk WILLIAM CALF: PHOTOGRAPHY 4129 E 6 ST ST. U INDIANAPOLIS IN 46220 L d I -7 ;FE -3i I "Vol E sluel Sexton co Sexton Co 902 i4 Cipita-1 AV D02',� Canita, Av fildianapolis IN 46204 h1diana IN 46204 m IPUe. Ande jzzi� F.D.B. Poifff TEA�FS YOU ORDEIq 1`40A F A PCC9UPFf h0. DAB 3Yrff'F EIS '�iTIPFC-D VIA 1 y J 00f 0 7 6�47 7 1TY DESCRIPTION -r: I AMOUNT, Y Mir Co or aerial riliot of Palachw�jj jyj Carlyle 6) 0, 0 0 v/ 4-6 priants CD ,6QQ( TOTA L INV. f DATE P.O. BOX 501423 INDIANAPOLIS, IN 46250 COURIER DISPATCH 595 -3500 BONDED INSURED PICKUP TIME SHIPPER NAME RECEIVER NAME s ADDRESS ADDRESS PHONE ZIP Q� PHONE ZIP MODE I HOUR ZHOU SAME DAY BY NOON NE C.O.D. CALL BY NOON NEXT DAY CALL SPECIAL INSTRUCTIONS: (G l AMOUNT DUE THIS INVOICE R1;� WE OPERATE U NDER I.U. R.C. GUIDELINES r THANK YOU ZG B.T.C. LTD. BECAUSE YOU CARE WE CARE I Invoice Number invoice Date Account Number Page 5- 728 -01633 Mar 18, 2010 1011- 0951 -8 a or a fiedEx Ground Shipment Detail B Reference 10riginal) P t 3cuP pa[ f Qb xiEtD Cusl Ref 2G9� x haybr Si�lppar P� 7rackiagED 00000052 519210037759 See ....a Shipment No. 44848574 SH1ELSE IUN Francoi Service Type InYI Ground P d Lacombe P 902 N CAPITOLAVE Ebeiusterioa Beaubois Ltee Zone 51 INDIANA1 IN 46204 -1005 5216E AV N Pack ages 1 SAINT- GEORGES Pt3 65Y oH1 Rated Waiyht 5lbs Delivered Feb 22, 2010 Transportation Charge Custa Fuel Sur char o 15.75 Entry Uato Feb 28, 2010 0.14 Tidal Charge USd S1fi.54 2695 Reference Subtotal USO X16.54 Total EedEx Ground GSD 596.54 I I i I i i i 'I i I" I i k I:z I 114VOICE 437 P Ind N. Illinois 5t. Endianapalis, IN 46204 ���/�r— P: 317,637.34315 Page Number 1 Ge years reprographix.com Date 2/2800 Invoice 102220 B SHIELI S GEOFF PRATT I ACCTS PAY- COLINDA WALKER H L SHIEL- SEXTON CO. INC. L 902 NORTH CAPITOL AVENUE P INDIANAPOLIS, IN 46204 T O p PLEASE REMIT TO: Repro Graphix, 437 N. Illinois St. Indianapolis, IN 46204 TOTAL DUE: 15.73 i 1 3/30110 2/28110 103701 2/22/10 n /30 CARMEL PAC 8 ADDM 4 Mm BLACKLINES 24X36 1 SF 186.0000 186.0000 .0700 13.02 DIGITAL BLACKLINE BOND PRINTS 14 ORIGS FOR 2 BLACKLINES 36X48 1 SF 24.0000 24.0000 .0700 1.68 DIGITAL BLACKLINE BOND PRINTS 1 ORIG FOR 2 0 1; 11111111111M I i i i i i. I I I 14.70 0.00 0.00 1.03 0.00 15.73 TOTAL DUE 15.73 P .r'• 437 N. Illinois St. mom INVOICE Indianapolis, IN 46204 REPRO mom G APHIM P 317.637.34 Page Number 1 reprographix.com Date 2/28/10 Invoice 102370 B SHIELI S CONTACT: GEOFF PRATT ACCTS PAY- COLINDA WALKER H L SHIEL SEXTON CO. INC. I L 902 NORTH CAPITOL AVENUE P T INDIANAPOLIS, IN 46204 T 0 0 PLEASE REMIT TO: Repro Graphix, 437 N. Illinois St. Indianapolis, IN 46204 TOTAL DUE: 596.20 i 3130/10 2/28/10 103425 2/12/10 n/30 2695 CARMEL PKG 6 i SPEC BOOKS 8.5X11 1 EA 314.0000 314.0000 .0400 12.56 BLACK WHITE PRINTS 314 ORIGS FOR 1 COVERS FOR SPEC BOOK 1 EA 4.0000 4.0000 1000 0.40 FRONT AND BACK COVERS 4FOR1 i GBC BINDERS 1 EACH 2.0000 2.0000 1.5000 3.00 PUNCH AND BIND WITH BINDER I SPEC BOOKS. 8.5X11 1 EA 62.0000 62.0000 .0450 2.79 i BLACK& WHITE PRINTS .62 ORIGS FOR 1 COLORED PAPER BLACKLINES 36X48 1 SF 7,692.0000 7,692.0000 .0700 538.44 DIGITAL: BLACKLINE BOND PRINTS j 641 ORIGS FOR 1 I. �i i 557.19 0.00 0.00 39.01 0.00 596.20 SMS I• TOTAL DUE 596.20 V A y Stale Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 207 (Rev. 1995) CITY OF CARMEL 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. Payee Sh 1 e Se ph omt Q n y 1 r) Purchase Order No. 902 l- &G,fj AVch4� Terms 1 �!v An IIS ./U ��J�U� Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) zGIL)5 '�5 �r �1 272,16 Total 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 Clerk- Treasurer HER NO. WARRANT NO. ALLOWED 20 -5 Al Irl seXioh camuan i-O IN SUM OF O'� 7 2, 9 ON ACCOUNT OF APPROPRIATION FOR T 1 i 1110 902-1'4q6e K7 Board Members PO# or D PT. INVOICE NO. ACCT #!TITLE AMOUNT I hereby certify that the attached invoice(s), or �Q L Q-C tH609 ,%jj Z 7 j� 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 �1. U 2010 Signature 9ire6tnr of j3priAvelopment Title Cost distribution ledger classification if claim paid motor vehicle highway fund