172831 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 00352077 Page 1 of 1
ONE CIVIC SQUARE FLUID WASTE SERVICES INC CHECK AMOUNT: $447.75
CARMEL, INDIANA 46032 Po eox 264
FISHERS IN 46038 CHECK NUMBER: 172831
CHECK DATE: 512712009
D ACCOUNT PO NUMB I NVOICE NUMBER AMOUNT DESCRI
206 4237001 0929763 447.75 STORM SEWER MAINT SUP
Ji
Fluid Waste Services, Inc. Invoice
P. O. Box 264
Date Invoice
Noblesville, IN 46061
317 773 -7996 5/8/2009 09 -29763
Bill To
City of Carmel Street Department
3400 West 131 st Street
Westfield, IN 46074
P.O. No. Terms Project
VERBAL Due on receipt.
Quantity Description Rate Amount
MAY 8, 2009 JG /AH 5822
GRAY RD NORTH OF 126TH ST
CLEAN 300' OF 15" RCP LINE
ROOTCUT TO RESTORE FLOW
1.75 JET AND VAC WITH COM13INATION CLEANING TRUCK 225.00 393.75
1 WATER METER RENTAL AND 1 -120 USAGE FEE 54.00 54.00
Thank You for Your Business.We accept Visa,MC Discover.Ptease reference Inv. No. On Remittance
Total $447.75
VOUCHER NO. WARRANT NO.
ALLOWED 20
Fluid Waste Service
IN SUM OF
i'. O. Sox 264
Noblesville, IN 46061
$447.75
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT #!TITLE AMOUNT Board Members
206 09 -29763 42- 370.01 $447.75 1 hereby certify that the attached invoice(s), or
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
Thursday, N4 21, 2009
Street Commissioner
Stra
Title
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.
Term s
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/08/09 09 -29763 $447.75
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