HomeMy WebLinkAbout156247 02/06/2008 °re CITY OF CARMEL, INDIANA VENDOR: 190300 Page 1 of 1
ONE CIVIC SQUARE M R S, INC
CARMEL, INDIANA 46032 P 0 Box 488 CHECK AMOUNT: $22,800.00
HAWESVILLE KY 42348
CHECK NUMBER: 156247
CHECK DATE: 2/6/2008
DEPARTMENT ACCOU PO NUMBER INVO NUMBER AMOUNT DESCRIPTION
651 5023990 12408 22,800.00 OTHER EXPENSES
Moffitt Re -Hab Service, Inc Invoice: 12408
PO Box 488
Hawesville, KY 42348
(270) 927 -8948
Sold Ship
to to
CARMEL WASTEWATER TREATMENT REHAB WILSON LIFT STATION
9609 HAZEL DELL PARKWAY 9609 HAZEL DELL PARKWAY
INDIANAPOLIS, IN 46280 CARMEL, IN 46280
Invoice
Account P.O. Num Ship Via Ship Date Terms Date Page
CARWASTE Sf0� -3 Net 30 1/24/08 1
Unit Extended
Item Quantij Description Price Price
1 Rehab Wilson Lift Station per Quote 28500.00 28,500.00*
1 Less 20% retainage for clean -up and
restoration 5700.00 5,700.00*
means item is non taxable Subtotal 22,800.00
Total $22,800.00
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
b
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
190300
Moffitt Rehab Services Purchase Order No.
P.O. Box 488 Terms
Hawesville, KY 42348 Due Date 2/1/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/1/2008 12408 $22,800.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
V
Date Offi
VOUCHER 077230 WARRANT# ALLOWED
190300 IN SUM OF.$
b,
Moffitt Rehab Services
P.O. Box 488
Hawesville, KY 42348
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
3 5Y0,
12408 02- 2308 -00 $22,800.00
Depreciation
Voucher Total $22,800.00
IN
Cost distribution ledger classification if
claim paid under vehicle highway fund