191163 10/27/2010 CITY OF CARMEL, INDIANA VENDOR: 00353052 Page 1 of 1
e ONE CIVIC SQUARE CONCRETE SURGEONS INC
CARMEL, INDIANA 46032 5705 W 73RD ST CHECK AMOUNT: $295.00
M, INDIANAPOLIS IN 46278 CHECK NUMBER: 191163
CHECK DATE: 10/2712010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 26884 295.00 OTHER EXPENSES
THE CONCRETE SURGEONS, INC. I n v oice
5705 WEST 73RD STREET
INDIANAPOLIS, IN 46278
317 291.0600
800; 822.3844 FAX (317) 291 -0606
10!4/2010 26884
CARMEL UTILITIES
760 3RD AVENUE SW, STE 110
CARMEL, IN 46032
JEFF COOPER Net 30
DESC
LIFTSTATION 12501 N. PENNSYLVANIA ST.
DIESEL SLAB SAW 2-6' CUTS THRU 6" DEEP CONCRETE LID 295.00 295.00
WENT TO LOWES GOT SHEET OF PLYWOOD
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The Concrete Surgeons
assume no liabililty whatso-
ever for layout of wall/ 'Thank you for your business
floor openings. holes or
lines, or for cutting any
buried electrical, gas or
water -sewer lines. ®TA L $295.00
VOPCHER 106442 WARRANT ALLOWED
00353052 IN SUM OF
CONCRETESURGEONS
5705 W. 73RD ST
INDIANAPOLIS, IN 46278
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO* INV ACCT* AMOUNT Audit Trail Code
'73GU
26884 01- 7-362,O& t1 y $295.00
Voucher Total $295.00
Cost distribution ledger classification if
claim paid under 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
00353052
CONCRETE SURGEONS Purchase Order No.
5705 W. 73RD ST Terms
INDIANAPOLIS, IN 46278 Due Date 10/20/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/20/2011 26884 $295.00
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
Date Officer