160068 05/28/2008 CITY OF CARMEL, INDIANA VENDOR: 359498 Page 1 of 1
ONE CIVIC SQUARE SHELBY MATERIALS
CARMEL, INDIANA 46032 P o Box 242 CHECK AMOUNT: $1,415.71
SHELBYVILLE IN 45176
CHECK NUMBER: 160068
CHECK DATE: 5/28/2008
DEPARTMENT AC PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
505 4238900 322045 1,415.71 OTHER MAINT SUPPLIES
INVOICE
CUSTOM R NO CANE ENVOICE NfJ PAGE a`s
rnr
M A T E R I A L 8
"Me Concrete and Aggregate Experts "CT BRO01 05/10/2008 3 2 2 0 4 5 1
34 398 -4485 FAX 317 398 -2727
BROOKSHIRE GOLF CLUB Send remittance to:
CITY OF CARMEL
12120 BROOKSH I RE PKWY S P O. B M aterials 2 S
CARMEL IN 46033 Please attach top part Shelbyville, Indiana 46176
with your remittance. Detach Here
4P' a, JOR NUI4itBER�JOB LOCATION ADDRESS s PER'
TI3AT�E r a 4 a P,,RIGE TAXI TOTALS,
,T,iCKEfrN17 .w r C�Lt/ NTITY UAW IT �,��::4v"A"' C.RIPTIE]N,< 'a UI�IIT a I"I Q2,
000201 GOLF COURSE
PO NUMBER: G -98
05/02 032- 405736 24.14 TN TOP DRESSING SAND 20.500 494.87
05/02 032 405736 24.14 TN DELIVERY CHARGE 9.000 217.26
05/02 032 405779 23.85 TN TOP DRESSING SAND 20.500 488.93
05/02 032 405779 23.85 TN DELIVERY CHARGE 9.000 214.65
JOB TOTAL LINE 1415.71
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y 1415.71
INVOICE �AMOUNT g DUE-
TERMS: NET 30 DAYS -THERE WILL BE A FINANCE CHARGE OF 2.00% PER MONTH (24% PER3�
ANNUM) ON ALL ACCOUNTS PAST 30 DAYS, ALL ACCOUNTS, WITHOUT PRIOR APPROVAL,
WHICH HAVE OUTSTANDING BALANCES OVER 90 DAYS, WILL BE TEMPORARILY PLACED ON
C.O.D. THE ACCOUNT WILL REMAIN ON A C.O.D. BASIS UNTIL BALANCE IS PAID OR SUITABLE 7
ARRANGEMENTS ARE MADE WITH THE CREDIT DEPARTMENT. ALL ACCOUNTS TURNED
OVER FOR COLLECTION WILL INCUR REASONABLE ATTORNEY FEES AND COURT COSTS TO
BE PAID BY THE PURCHASER WITH PROPER VENUE AS SHELBY COUNTY.
CC750392 (4101) TIP 00 -2806
ru www.shelbymaterials.dom
PROPERTY DAMAGE RELEASE
P•7. BOX 242 Dear Customer -The driver of this truck in presenting this RELEASE to you for your signature is of the opinion
1 that the size and weight of his truck may possibly cause damage to the premises andlor adjacent property it
re
a A T E M I A L- S 'SHELBYVILLE IN 46176 he places the material in this load where you desire it. It is our wish to help you in every way that we can,
"The ConcMe and Aggregate Experts" 0 WASHED SAND GRAVEL but in order to do this the driver is requesting that you sign this RELEASE relieving him and this supplier from
CRUSHED LIMESTONE any responsibility from any damage that may occur to the premises and/or adjacent property, buildings,
Edinburgh 1.800 -472 -8352 sidewalks, drive ways, curbs, etc., by the delivery of this material, and that you also agree to help him remove
She/ tTyville 1-800- 548 -951s READY MIXED CONCRETE mud from the wheels of his vehicle so that he will not litter the public street. Further, as additional
l MECHANICS UEN consideration, the undersigned agrees to indemnify and hold harmless the driver of this truck and his supplier
NOTICC.Thetndisna Mac- anic&Uen$tMutb W# gM& OrOHitationofa lowrwoowpeM.ofWendedo.v o=ipenbd for any and all damage to the premises and/or adjacent property which may be claimed by anyone to have
tM rwrvlNrga of materialss air services for ft alteration or repair of the wiow conetn,etlon of aw 4e or dawow remlly arisen out of delivery of this order.
dwellmpe. To the e.lent that the mean" or services filled elsewmie hereon have and somional materials or servkee may
be lurfrdred by Irm coinparry W such purpose! INS notice ls hereby glum. 'SHOULD THESE MATERIALS OR SERVICES X
NOT q PAID FOR IN THE ORDINARY COURSE OF BUSINESS THIS COMPANY WILL HAVE THE RIGHT TO CLAIM A
MECHANICS LIEN U PON T HE PREMISES FOR WHICH THEY ARE FURNISHED AS PRESCRIBED IN THE INDIANA
MECHANICS LIENS TICKET DATE TIME
SHIPPED FROM:
SOLD TO: u r la
JOB ID:
DESCRIPTION QUANTITY UM PRICE AMOUNT
GROSS WT: TARE WT: NET WT: TAX
DELIVERY Customer agrees to maintain a suitable roadway to point of delivery and customer assumes
responsibllity and shall indemnity seller for truck damage and property damage between curb and TOTAL
point of delivery.
TRUCK WAITIRB TIME Customer agrees to pay for excess truck time at current rate of seller for trucks
held at place of delivery over the allowable. �l
TERMS Net 10th of month following shipment. Purchaser agrees to pay all collection costs, attorney's RECEIVED BY SIGN FULL NAME
fees If collected by suit or otherwise. 1.75% Interest Per Month �u NO INITIALS
www.shelbymaterials.com PROPERTY DAMAGE RELEASE
P.O. BOX 242 Dear Customer The driver of this truck in presenting this RELEASE to you for your signature is of the opinion
RA .e. r E R I ,4 s SHELBYVILLE, IN 48176 that the size and weight of his truck may possibly cause damage to the premises and/or adjacent property if
he places the material in this load where you desire it. It is our wish to help you in every way that we can,
"The Concrete and Aggregate Experts" (9) WASHED SAND GRAVEL but in order to do this the driver is requesting that you sign this RELEASE relieving him and this supplier from
CRUSHED LIMESTONE any responsibility from any damage that may occur to the premises and /or adjacent property, buildings,
Edinburgh 1- 800 472.8352 sidewalks, drive ways, curbs, etc., by the delivery of this material, and that you also agree to help him remove
Shelbyville 1- 800. 548.9516 READY MIXED CONCRETE mud from the wheels of his vehicle so that he will not litter the public street. Further, as additional
consideration, the undersigned agrees to indemnify and hold harmless the driver of this truck and his supplier
MECHANICS LIEN for any and all damage to the premises and/or adjacent property which may be claimed by anyone to have
arisen NOTICE: The Indiana Me&4n" Lien Ststum rsqui; the rtotR"tk n ot al ownw oocupwo w imandsd ownr owipems d isen out of deliv of this order.
ero lwniJNrVs or materials w wrvioae 1w ft sftersibn w petr rs of Ihs origisel ccnatniction of sloe or double feWly ry
dwa h ps. To Ms scent that the materials or sarvirbs listed etsewhera hereon hew and adc ibonai materiHa Of aerACee may
be furnished by ms company for such purposes the nolios is hereby alven. "SHOULD THESE MATERIALS OR SERVICES X
NOT BE PAID FOR IN THE ORDINARY COURSE OF BUSINESS THIS COMPANY WILL HAVE THE RIGHT TO CLAIM A
MECHANICS LIEN UPON THE PREMISES FOR WHICH THEY ARE FURNISHED AS PRESCRIBED IN THE INDIANA TICKET DATE TIME
MECHANICS LIEN STATUTE'
SHIPPED FROM:
SOLD TO:•'_ l_ L
JOB ID:
DESCRIPTION QUANTITY UM PRICE AMOUNT
GROSS WT: TARE WT: NET WT: r
TAX
DELMNY Customer agrees to maintain a suitable roadway to point of delivery and customer assumes
responsibility and shall indemnify Seller for truck damage and properly damage between curb and TOTAL
point of delivery.
TRUCK WAITING TIME Customer agrees to pay for excess truck time at current rate of seller for trucks
held at place of delivery over the allowable. R
TERMS Net 10th of month following shipmem. Purchaser agrees to pay all collection costs, attorney's RECEIVED BY [J4`�` il` SIGN FULL NAME
fees M Collected by suit or otherwise, 1.75% Interest Per Month NO INITIALS
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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.
*z.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s)) ^7
5-00 U 3a a o V 5 /�/r,�r
Total IV/S7 7
1 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