192516 12/07/2010 f CITY OF CARMEL, INDIANA VENDOR: 358820 Page 1 of 1
ONE CIVIC SQUARE NOBLESVILLE LANDFILL
0 CHECK AMOUNT: $100.00
CARMEL, INDIANA 46032 1301 s 8TH STREET
NOBLESVILLE IN 46060 CHECK NUMBER: 192596
CHECK DATE: 12/7/2010
DE PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350100 12823 100.00 BUILDING REPAIRS MA
Nobj vnflk
DATE INVOICE
11/17/2010 12823
TERMS
Due on receipt
BILL TO
Carmel Street Department
3400 W 131 st Street
Carmel, IN 46074
`Date Product` Ti6Ket/Truck Number Quantity Rate Amount
11 /01 /2010 Road Kill:Deer 59173 1 25.00 25.00
11/08/2010 Road Ki11:Deer 59306 1 25.00 25.00
11/10/2010 Road Kill:Deer 59361 1 25.00 25.00
11/15/2010 Road Kill:Deer 59461 1 25.00 25.00
SUBTOTAL $100.00
TAX (7 $0.00
TOTAL $100.00
1801 S. 8" Street Noblesville, IN 46060
317 -770 -8155 o Fax 817 -770 -8999
Nob 11andfill ville 59173
In c Jno/V
c
Phone:
Date: j 1 1 L
JOB NAME:
Pick up /small trailer Cl Semi -dump
Single axle /large trailer 20 yd dump box
Tandem axle 40 yd dump box
Tri axle
CIRCLE ONE: �O 2_ e
mp Fee Pill Dirt Other
d P-Gravel C F
Top Soil, unpulver Top Soil, pulverized
OF LOADS idle e
OF LORDS OUT.
®river's Signature
Truck Z0
REMN TO: R.E. FRASH
1 801 S. eth 37 IlC LET
HO®LEMLLC OM 46060
(317) 770 -8166
Nob 11andfill ville 59306
Inc or v,
Phone:
Date: 5 Z
JOB NAME:
Type of Truc
Pick up /small trailer Semi -dump
Single axle /large trailer 20 yd dump box
Tandem axle 40 yd dump box
Tri axle er
CIRCLE ONE: 0 e e
p Fee Fill Dirt Other
Screens P= Gravel C F
Top Soil, unpulverized Top Soil, pulverized
OF LOADS H:
OF LOADS OUT
Driver's signatuve
Truch IS7 S
G°,3EMOT TO: H.E. F ASGT
1301 So h STREET
NOO BLES MLLE, ON 46 600
3177) 770-0155 155
Nob esville 59361
an dfll Inc Iv ey
G
Phone:
Date: j -1c)-lo
JOB NAME:
Pick up /small trailer Semi -dump
Single axle /large trailer 20 yd dump box
'Tandem axle 40 yd dump box
Tri axle er
CIRCLE ONE: J e_r
um Fe Fill Dirt Other
Screened Sand P-Gravel C F
Top Soil, unpulverized Top Soil, pulverized
OIL LOADS 0H:
OF LOADS OUT
G°�C�f����OOo Rn°oCo l�G°�Q
I Gal So h 67REET
HOO BLEWLL E, H 4600600
31 770-8 1 X56
No' L andfill vi lle 59461
Inc Ihar_.�
caf
Phone:
Date:
JOB NAME:
Pick up /small trailer Semi -dump
Single axle /large trailer 20 yd dump box
Tandem axle 40 yd dump box
T'ri axle Qc6iw?
CIRCLE ONE: o e- e r
m Fill Dirt Other
Screene P- Gravel C F
Top Soil, unpulverized Top Soil, pulverized
OF LOADS ifs:
OF LOADS OUT:
Driver's u v
Tru
1801 S. th 3THE T
HOLE MCI LE, 9H 46060
31 7) 770-8135 o 166
i
VOUCHER NO. WARRANT NO.
ALLOWED 20
Noblesville Landfill
IN SUM OF
1801 S. 8th Street
Noblesville, IN 46060
$100.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 12823 43- 501.00 $100.00 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
j Thursday, December 02, 2010
)0,
Street Commi
Street Gornff�:
Cost distribution ledger classification if
claim paid motor vehicle highway fund
Prescribed by State Board of Accounts City Form No. 261 (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))
11/17/10 12823 $100.00
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
,20
Clerk- Treasurer