191765 11/10/2010 °4 CITY OF CARMEL, INDIANA VENDOR: 358820 Page 1 of 1
ONE CIVIC SQUARE NOBLESVILLE LANDFILL
O CHECK AMOUNT: $50.00
CARMEL, INDIANA 46032 1801 5 8TH STREET
NOBLESV LLE IN 46060 CHECK NUMBER: 191765
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350100 12771 50.00 BUILDING REPAIRS MA
No vffie
Rnc
10/31/2010 12771
TERMS•
Due on receipt
B,ILLT
Y o.4
Carmel Street Department
3400 W 131st Street
Carmel, IN 46074
Date Pfoduct �cket/Truck:Nurnber 3 Quantity Rate Amount f
M
10/13/2010 Road Kill:Deer 58858 1 25.00 25.00
10/27/2010 Road Kill:Deer 59081 1 25.00 25.00
SUBTOTAL $50.00
TAX (7 $0.00
TOTAL: $50'QQ
1801 S. 8 Street o Noblesville, IN 46060
317 -770 -8155 o Fax 317- 770 -8999
N ®b H L andfill vi lle 58858
In W e o
C a r vn e l S -�;-e e-� 0g,&
Phone:
Date 10
JOB NAME:
P.
Pick up /small trailer Semi- dump
Single axle /large trailer 20 yd dump box
Tandem axle 40 yd dump box
Tri axle Oth
CIRCLE ONE: re k-
Dump Fee Fill Dirt: Other
Screened Sand P- Gravel C F
Top Soil, unpulverized Top Soil, pulverized
OF LOADS ON. I
OF LOADS OUT-
orlyev's sig 2
REPA07 TO: H.E.
1@01 S. Mh STREET
MOI LES MLLE, H 46060
(317) 770-0135
No' vi lle 59081
Inc
Car me
Phone:
Date: l o f L L/ 0
JOB NAME:
fte off Truce
Pick up /small trailer Semi -dump
Single axle /large trailer 20 yd dump box
Tandem axle 40 yd dump box
T'ri axle her
CIRCLE ONE: te
NPV'mp Pee Fill Dirt Other
Screen d P= Gravel C F
Top Soil, unpulveri Top Soil, pulverized
OF LOADS H: 1
OF LOADS OUT.
Driver' Driver Sig
Truck
HEMF TO.- R.E. FHASW
�p
1801 01 S. Gth 67REET
HOOLEMLL E, U 46060
(317) 770 -6155
VOUC NO. WARR NO.
Noblesville Landfill ALLOWED 20
IN SUM OF
1801 S. 8th Street
Noblesville, IN 46060
$50.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Membei
2201 12771 43- 501.00 $50.00 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
�hursday, Nove ber 04, 201C
J p 7 4
f, //,7g A
8 1 J
Street Commissioner
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))
10/31/10 12771 50.00
f hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and 1 have audited same in accordance
with IC 5- 11- 10 -1.6
2Q
Clerk Treasurer