179111 11/11/2009 CITY OF CARMEL, INDIANA VENDOR: 00352914 Page 1 of 1
0` ONE CIVIC SQUARE AMERICAN INDUSTRIAL SERVICES CHECK AMOUNT: $531.20
CARMEL, INDIANA 46032 8500 GEORGETOWN ROAD
INDIANAPOLIS IN 46268 CHECK NUMBER: 179111
CHECK DATE: 11/11/2009
s� EPA 3TMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 29W874A 531.20 OTHER EXPENSES
A INVOICE 8500 Georgetown Road
Indianapolis, IN 46268
Phone: (317) 871 -4090
,,u Fax: (317) 871 -4094
TOLL FREE 1- 800 877 -4955
INVOICE NUMBER: 29WS74A -IN
INVOICE DATE: 09/30/2009
CARMEL HHW JOB NUMBER: 29W374
ONE CIVIC SQUARE
CARMEL, IN 46032 JOB DESC: CITY OF CARMEL- ROLLOFF
CONTACT: JOB LOCATION:
CONTRACT NO.: S07574
AEC CONTACT: GLS
.WORK PERFORMED ON 9/23/09
WASTE MANAGEMENT SERVICES
DESCRIPTION UNITS PRICE/UNIT TOTAL
TRANSPORTATION/MILE 1.00 S 200.00 S 200.00
BULK NON -REG 5.52 S 60.00 S 331.20
TOTAL
INVOICE S 531.20
INVOICEDUENET 30 DAYS
LATE PAY11ENTS WILL BE CHARGED INTEREST AT 1.5% PER MONTH
3700 W Grand Ave. Ste. A 410 Production Court
Springfield, IL 62711 www.americanenvironmental.net Louisville, KY 40299
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
7
00352914
Y'
AMERICAN INDUSTRIAL SERVICES Purchase Order No.
8500 Georgetown Road Terms
Indianapolis, IN 46268 Due Date 11/5/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/5/2009 29W874A $531.20
2
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
It X
Date Officer
VOUCHER 096707 WARRANT ALLOWED
00352914 IN SUM OF
AMERICAN INDUSTRIAL SERVICES
8500 Georgetown Road
Indianapolis, IN 46268
Carmel Wastewater Utility
ati
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
29W874A 01- 736H -08 $531.20
;5
r
Voucher Total $531.20
Cost distribution ledger classification if
claim paid under vehicle highway fund