155905 01/23/2008 CITY OF CARMEL, INDIANA VENDOR: 00350511 Page 1 of 1
ONE CIVIC SQUARE SMOCK FANSLER CORP
CARMEL, INDIANA 46032 2910 W MINNESOTA ST CHECK AMOUNT: $17,165.00
INDIANAPOLIS IN 46241 CHECK NUMBER: 155905
CHECK DATE: 1/23/2008
DE PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 R4350900.17514 2035 17,165.00 96 /WESTFIELD RND REPA
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01/04/08 09:16 FAX 81751 HYLANT GROUP CARMEL 10002
To:98175151
JAN -04 -2008 07:59 From:
SMOCK FANSLER CORPORATION T;ivoice No 2035
2910 W. MINNESOTA STREET
fND1ANAPOLIS, TN 46241 -4541 Page 1
Tel. 317) 248 8371
Fax 31 7) 486 -5269 Smo ck Fansler
l'ON VOk A'TI ON
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L CITY OF CAFtME2� O 07189
L M4E CIVIC SQUARE WESTFT39M 96TH ROUNDABO
CARL�L xN 46032
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O p.
Invoice.Date :Invoice .Wo. Customer No. Payment Teinris Contact No.
12/31/07 2035 055126 NET 30 DAYS
Unit Expended
Quantity D e s c r i p t i o n Price Iari ce
96TR STREET 6 WESTnXLD BLVD ROUNDABOUT REPAIR
ORIGINAL CMZ AC T $20,410.00
URN ALLOWANCE 1,250.00
TOTAL 19,130.00
TOTAL AMOUNT DUE THIS INVOICE 19,130.00
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4 6 (n
c ross Retainage Tax Not Amount
19,130.00 .00 .00 19,130.00
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
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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
161"1 0LK C��10 tl� Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
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QIiV, UJ �J�r
QJ�1 lC`
Total
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
�1�1 -rQ IUD Lti►� IN SUM OF
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ON ACCOUNT OF APPROPRIATION FOR
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Board Members
PO# or
DEPT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
1L05,od 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
,14N 2Q0� 20
Sign re b
=J Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund