167684 01/07/2009 CITY OF CARMEL, INDIANA VENDOR 357892 Page 1 of 1
t' ONE CIVIC SQUARE PROFORM PIPE LINING CO INC CHECK AMOUNT: $9,845.00
CARMEL, INDIANA 46032 226 S ELDER
MISHAWAKAIN 46544 CHECK NUMBER: 167684
CHECK DATE: 1/7/2009
DEPARTMENT ACCOUNT PO NUMBER INVOIC N UMBER DESCRIPTION T
651 5023990 PF1265 9,845.00 OTHER EXPENSES
i3/-�
ProForm Pipe Lining Co., Invoi
226 S. Elder
Mishawaka, IN 46544 Date Invoice
12/8/2008 PF -1265
Bill To Ship To
Carmel Waste Water Treatment
9609 Hazel Dell Parkway
Indianapolis, IN 46280
P.O. No. Terms Due Date
Net 10 days 12/8/2008
Description Serviced Amount
Mobilization fee. 800.00
Liner installation 8" 7.5 mill x 143 If 8
Vaetor and televising unit 850.00
Thank you for your business. Total
$9,845.00
Phone Fax
574 -259 -0903 574 257 -0992
Page 2
VOUCHER 086992 WARRANT ALLOWED
357892 IN SUM OF
PROI=ORM PIPE LINING CO INC
226 S ELDER
MISHAWAKA, IN 46544
I�
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
PF1265 01- 7360 -02 $9,845.00
9
U Voucher Total $9,845.00
Cost distribution ledger classification if
claim paid under ve icle hi hway 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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
357892
PROFORM PIPE LINING CO INC Purchase Order No.
226 S ELDER Terms
MISHAWAKA, IN 46544 Due Date 12/29/2008
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/29/200! PF1265 $9,845.00
hereby certify that the attached invoice(s), or biil(s) is (are) true and
=rect and I have audited same in accordance with IC 5- 11- 10 -1.6
doZz
Date 1 O f 6 g6 r