199057 07/06/2011 CITY OF CARMEL, INDIANA VENDOR: 141050 Page 1 of 1
ONE CIVIC SQUARE INDEPENDENT CONCRETE PIPE
CARMEL, INDIANA 46032 INDIANA DIVISION CHECK AMOUNT: $1,509.03
t 'fi!+ PO BOX 2847
CHECK NUMBER: 199057
INDIANAPOLIS IN 46206 -2847
CHECK DATE: 716/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 305956 1,509.03 MATERIALS SUPPLIES
I N V O I C E
INDEPENDENT CONCRETE PIPE CO. JINVOICE#JPAGE
INDIANA DIVISION 305956 1
2050 S. Harding INVOICE DATE
Indianapolis, IN 46221 0 6 7 10 11
REMIT TO:
Phone: 317 -262 -4920 INDEPENDENT CONCRETE PIPE CO.
IN DIVISION
PO BOX 2847
INDIANAPOLIS, IN 46206 -2847
SOLD CITY OF CARMEL SHIP Calvin
TO 3400 West 131st Street TO P
Westfield IN 46074 t 1
Po CALVIN
ORDER DATE CU ST.# rLOC.TSLM.T PURCHASE ORDER N0. SHIP VIA
4051 06/10 11 000520 IN R WIL PICK UP
QTY. QTY.
ORDER /B.O SHIP /RET ITEM N O. /D ESC. UNI UDM NET PRICE
2.00 2.00 0 048MH48 264.0000 EA.- 528.00
1.00 48 MANHOLE RISER 48 TALL .00
Ticket 040511 -001 2.00
2.00 2.00 0 048FT24 165.0000 EA 330.00
1.00 48° FLATTOP WITH 24 HOLE .00
Ticket 040511 -001 2.00
2.00 2.00 0 2T 300.0000 EA 600.00
1.00 2- TON CLUTCH LIFTER .0@
Ticket 040511 -001 2.00
Original Copy
SALES AMOUNT, 1,458.00
COMMENT
SURCHARGE' 51.03
FREIGHT .00
SALES TAX .00
TOTAL 1,509.03
TERMS Net 30 days AMOUNT.RECEIVED .00
BALANCE DUE 1,509.03
VOUCHER 115377 WARRANT ALLOWED
141050 IN SUM OF
INDEP CONCRETE PIPE CO
INDIANA_D.IVISION,
1 (1111f\ \J11 1 P' 1 /I/1 /Y6- 0) 0 6
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
305956 01- 7200 -02 $1,509.03
i
Voucher Totaf $1,509.03
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
141050
INDEP CONCRETE PIPE CO Purchase Order No.
INDIANA DIVISION Terms
SECTION 935 Due Date 6/27/2011
LOUISVILLE, KY 40289
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/27/2011 305956 $1,509.03
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