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202115 09/27/2011 CITY OF CARMEL, INDIANA VENDOR: 358385 Page 1 of 1 ONE CIVIC SQUARE GENERAL SHALE BRICK CHECK AMOUNT: $956.09 CARMEL, INDIANA 46032 PO BOX 5825 CAROL STREAM IL 60197 -5825 CHECK NUMBER: 202115 CHECK DATE: 9/27/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 R4462000 21371 181463710 567.45 STRUCTURAL IMPROVEMEN 2201 4236100 181497802 194.32 SAND 2201 4236100 181502498 194.32 SAND General Shale Brick M Building The American Dream Invoice: 181497802 Invoice Date: 09/07/2011 Bill To: 279670 Customer PO: hand rail CITY OF CARMEL 3400 W 131ST STREET Bill of Lading: 171677084 WESTFIELD IN 46074 -8267 Goods Issue Date: 09/07/2011 Order: 313 8532 01 Sales Rep: 399 Ship -To: CITY OF CARMEL Order Loc.: Carmel 3400 W 131ST STREET CARMEL IN WESTFIELD IN 46074 -8267 Phone: 317- 846 -2566 Mode of Shipment: Customer Pickup 057 Material Material Description Quantity Price Value USD Batch Number and Description 6099008469 50 LB. OF SAND 56 BAG 3.47 194.32 Subtotal 194.32 TAX TOTAL 194.32 LATE PAYMENT CHARGE of 1.S% PER MONTH. General Shale Brick ®ill.E Building The American Dream' l ice Invoice: 181502498 Invoice Date: 09/14/2011 Bill To: 279670 Customer PO: HAND RAIL PROJECT CITY OF CARMEL 3400 W 131ST STREET Bill of Lading: 171682068 WESTFIELD IN 46074 -8267 Goods Issue Date: 09/14/2011 Order: 313883603 Sales Rep: 399 Ship -To: CITY OF CARMEL Order Loc.: Carmel 3400 W 131ST STREET CARMEL IN WESTFIELD IN 46074 -8267 Phone: 317 -846 -2566 Mode of Shipment: Customer Pickup 057 Material Material Description Quantity Price Value USD Batch Number and Description 6099008469 50 LB. OF SAND 56 BAG 3.47 194.32 Subtotal 194.32 TAX TOTAL 194.32 LATE PAYMENT CHARGE of 1.5% PER MONTH. VOUCHER NO. WARRANT NO. ALLOWED 20 General Shale and Brick IN SUM OF P. O. Box 5825 Carol Stream, IL 60197 -5825 $388.64 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 181497802 42- 361.00 $194.32 1 hereby certify that the attached invoice(s), or 2201 181502498 42- 361.00 $194.32 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 a l T�ursday, Septem 22, 2011 Street Commissioner �iie` Cost distribution ledger classification if claim paid motor 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 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)) 09/07/11 181497802 $194.32 09/14111 181502498 $194.32 1 hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 2a Clerk- Treasurer General Shale Brick W0=ME Building The American Dream Invoice: 181463710 Invoice Date: 07/15/2011 Bill To: 279670 Customer P0: 111TH ON THE MONON CITY OF CARMEL 3400 W 131ST STREET Bill of Lading: 171640285 WESTFIELD IN 46074 -8267 Goods Issue Date: 07/15/2011 Order: 313634413 Sales Rep: 399 Ship -To: CITY OF CARMEL Order Loc.: Carmel 3400 W 131ST STREET CARMEL IN WESTFIELD IN 46074 -8267 Phone: 317 -846 -2566 Mode of Shipment: Customer Pickup 057 Job: 111TH ON THE MONON Material Material Description Quantity Price Value USD Batch Number and Description 6099009216 HANDICAP PAVERS 230 EA 2,250.00 517.50 6099032390 POLYSWEEP POLYMERIC SAND TAN 3 EA 16.65 49.95 Subtotal 567.45 TAX TOTAL 567.45 LATE PAYMENT CHARGE of 1.5a PER MONTH. Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 2Dt(Rev.1995) CITY OF CARMEL An invoice or bill to be property itemized must show: kind of service, where performed, dates service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee u'CL. S Purchase Order No. ?oig �g2 S Terms C_0' cS�r e.Qam r L_ Coo k9 S$Z Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) Total _T 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 VOUCHER NO. WARRANT NO. ALLOWED 20 l��flY4a �Y��te IN SUM OF S ON ACCOUNT OF APPROPRIATION FOR Board Members Po# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT. I hereby certify that the attached invoice(s), or 13� Eh -2cc S �•4S� 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 20 Signat re cc I„� Cost distribution ledger classification if Title claim paid motor vehicle highway fund