158539 04/15/2008 CITY OF CARMEL, INDIANA VENDOR: 00353063 Page 1 of 1
a 0 ONE CIVIC SQUARE MILLER PIPE LINE CORP
CARMEL, INDIANA 46032 s ►S"3 g9:(� P {GW HECK AMOUNT: $1,180.47
NUMBER: 158539
li +C� cro 1 06 86
C CHECK DATE: 4/15/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 S11087 210368 1,180.47 REPAIR GAS LINE
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MILLER PIPELINE: CORPORATION
I i I le r REMIT TO: 1853 RELIABLE PARKWAY
Pipeline CHICAGO, IL 60686
TELEPHONE: (317) 293 -0278
2086 208 660 13 PAGE: 1
BILL :10: CARMEL WASTEWATER
9609 HAZEL DEL., ROAD
INDIANAPOLIS IN 46280
JOB SITE: CARCMEL WASTEWATER
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9609 HAZEL .DEL ROAD
INDIANAPOLIS. IN 46280
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3/2 1x'08 01 1 IN 1 SS NET 30 DAYS 1 210368
LOCATION: .96TH HAZELDELL
FOREMAN: IDARRELL. ORR
f BILLING PERIOD: 3/5/08
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i PRODUCT UNITS RATE EXTENSION
,'CUT 1 1/2 PL LINE a CHANGE TO 2
INSTALLIED 2" RISER ON OUTSIDE OF
{BUILDING TO UNDERGROUND LEAK ON DINE
LABOR HOURS 14,.00 70.00 980.00
(MATERIAL 1.00 200.47 200.47
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SUB TOTAL: 1180.47
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INVOICE GROSS: 1180.47
SALES TAX AMT: .04
INVOICE NET: 1184.47
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I FORM #41 (REV. 11103)
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
00353063
MILLER PIPE LINE CORP Purchase Order No.
P.O. BOX 3913 Terms
Indianapolis, IN 46255 Due Date 4/1/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
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4/1/2008 210368 $1,180.47
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
VOUCHER 085195 WARRANT ALLOWED
00353063 IN SUM OF
"MILLER PIPE LINE CORP
tE53 QeI�Ab�P PXw��
Chic.QS I 1- 1606
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Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR.
Board members
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PO INV ACCT AMOUNT Audit Trail Code
210368 01- 7202 -06 $200.47
210368 01- 7362 -06 $980.00
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Voucher Total $1,180.47
Cost distribution ledger classification if
claim paid under vehicle highway fund