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186957 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 358820 Page 1 of 1 ONE CIVIC SQUARE NOBLESVILLE LANDFILL CHECK AMOUNT: $25.00 CARMEL, INDIANA 46032 1801 S 8TH STREET NOBLESVILLE IN 46060 CHECK NUMBER: 186957 CHECK DATE: 6/23/2010 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2201 4350100 1267 25.00 BUILDING REPAIRS MA No wMe andfifl ffnc °-DATE INVOICE 06/11/2010 12267 T[ RMS Due on receipt BILL TO Carmel Street Department 3400 W 131 st Street Westfield, IN 46074 Date "..Product Ticket/Truck Number Quantity Rate Amount 06/04/2010 Road Kill:Deer 55955 TK 54 1 25.00 25.00 SUBTOTAL $25.00 TAX (7 $0.00 TQTAL $25.00 1801 S. 8" Street o Noblesville, IN 45060 317 -770 -8155 o Fax 317- 770 -8999 lob L andfill vi lle 55955 Inc r P- Carmel S), Phone: Date: JOB NAME: Pick up /small trailer Semi dump giggibo trailer 20 yd dump box Tandem le 40 yd dump box I© Tri axle CIRCLE ONE: Fee Fill Dirt Other Screens Sand P-Gravel CF Top Soil, unpulverized Top Soil, pulverized OIL LOADS IN: OF LOADS OUT. Drivev's sig Ile YO Truck I1 I1L511 OT 70. H.E. FR 11 AS 1 601 01 S 0 6 STQEE7 ��pp p 31 7) 770-9135 V NO. WARRANT NO. ALLOWED 20 Noblesville Landfill IN SUM OF 1801 S. 8th Street Noblesville, IN 46060 $25.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# 1 Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Member 2201 1267 43- 501.00 $25.00 1 hereby certify that the attached invoice(s), or 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 Thursday,.,June 1#7 201C Str. @et;Commis, i5 er Title Cost distribution ledger classification if claim paid motor vehicle highway fund Prescribed by State Board of Accounts City Form No. 201 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER 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 Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 06/11/10 1267 $25.00 1 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