HomeMy WebLinkAbout204269 12/06/2011 CITY OF CARMEL, INDIANA VENDOR: 365399 Page 1 of 1
ONE CIVIC SQUARE INSITUFORM TECHNOLOGIES USA INC
t' CARMEL, INDIANA 46032 ATTN: BOX 674060 CHECK AMOUNT: $1,617.59
4400 AMON CARTER BLVD, SUITE 110 CHECK NUMBER: 204269
FT WORTH TX 76155
CHECK DATE: 1216/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 126294 1,617.59 OTHER EXPENSES
Attn: J ohn D uffy INVOICE
T0 Cit of Carmel,I I (Make Checks Payable to:
C armel U tilit ie s I INSITUFORM TECHNOLOGIES USA, INC
760 Th Aven SW S 110 Please Remit Payment to LOCK BOX I (Payment Appl ication- Two Retaina
C armel,IN 46032 IBBVA Com ass Bank Platform I P_O Ir i I i is12_o_58
Pho 13 1- 5 -2451 I Insituform Technologies I I--
Attu: E ric Haenl Attn: Box 674060 i J j 1 126
TO: Kessler Engin 14400 Amon Carter Blvd., Suite 110 i Wess Job '_9_1 104.03. 0 1
1 S. E Stree I Ft Worth Texas 761551 work period: i an��2011 4/812011
ndianapolis,_IN 46 I INDY Office 317 489 3867 Direct j A
pplication Date: 4!612
Phone 317 788-4551
Pro ject Carlin Sewer Rehabi
Cannel.IN 46032
_ITEM I CONTRAC COMPLE_T_E_ D THIS P COMPLETED_ -TO-D
NO DESCRIPTION 1 QUANTITY UNIT PRICE QUANTITY l AMOUNT OUANTITY (AMOUNT
1 I8' Insit formOCIP I 1 200! I I J ELL 24.801LF 11 641L F 1 1 _28,867.20 1 164 L I 28,867,20
_2 Lateral Renstatment 10 E 245.50 EA 10 EA 10 0 °�I 2,455_00 10_�EA II 2,455
3 UndstnbutedProt uding Tap Removal 5 EA' 257 40 EA 4 F�4 80% 1,029.60 4 E 1 1,029.60
4 Undi N stnbuted Sanity Sewer CCTV 10 0 LF 2 90LF 0 LF 0 %_0 0 L 1111 0_00
5 Undistr bated 10° CIPP Lining N 1 00' L I 62 70! LF I Of LF 0 O,00 0 LF i 0.00
I ,i iI
EARNED THIS PERIOD: S32.351.80 EARNED TO DATE: $32,351.80
CONTRACT SUMMARY Month Gross 532.351.80 I I _'_Less: R_etainage_� 0% 0.00
II �MOnth Retention 80_00 I I i
Total_ConVact Earned I 32,351.80 Month OpOpen_ 532 351_80 1 Previous Invoices 30 .734.21
_Less R_etainag 1 OAOf
_Customer# S12058 Other I
I
(Atteribon !John Duff Total Deductions from
Less:_ _II Eamed to Date 30 734.21
l u: D_eAnn Berry I_ I
Net Amount Due
(AMOUNT DUE
P aid to D ate: 30,734.211 f 6/2 7/2011 ;THIS ESTIMATE: 1 617.59
TOTA DUE 1 617.59
I I 'I /lheieareartv,�questiohs r ardin this payment application please _I
AMOUNT PAST DUE: $0.00 1 co ntact Ale 317.281 -3767 mobil
Fle Sharoe at 317 489-3867 office trnni F ,mils T r [ofnrmatinn
'For Overnight payments I II I ;3080 North Ceotnd Expresssny Pre pared by: ery Sbc:fr i t
I_ t— _Mthisr —s,7 ,AI_ Ind na,PM
I lnsitufonn Technologies USA Inc. 1 ForACHA t 1997445 I lnshuform I echnol ies USA, Inc.
Attn: Box 674060 For Fed. \Virr.1 119073.15 i
;4400 Amon Carter Blvd. Suite 110 t$wift Cods: CP,\s'USU _App by:
Ft Worth ,Texas 76155 II- BenTicla ry: Insituform Technologies, Inc. 4
I IACcount No: 2520837755 i
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
T0688
INSITLIFORM TECHNOLOGIES INC Purchase Order No.
Terms
Due Date 11/28/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/28/201' 126294 $1,617.59
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I ha ve audited same in accordance with IC 5- 11- 10 -1.6 /I
Date Officer
VOUCHER 116302 WARRANT ALLOWED
T0688 IN SUM OF
INSITUFORM TECHNOLOGIES INC
o 0
QJ 1 71-,1SS
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
126294 01- 7360 -02 $1,617.59
Voucher Total $1,617.59
Cost distribution ledger classification if
claim paid under vehicle highway fund