175659 08/06/2009 CITY OF CARMEL, INDIANA VENDOR: 00353052 Page 1 of 1
ONE CIVIC SQUARE CONCRETE SURGEONS INC
CARMEL, INDIANA 46032 5705 W 73RD ST CHECK AMOUNT: $495.00
INDIANAPOLIS IN 46278 CHECK NUMBER: 175659
CHECK DATE: 8/6/2009
DEPARTMENT ACCO PO N UMB ER IN NUMB AMOUNT DESCRIPTION
651 5023990 25003 495.00 OTHER EXPENSES
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THE CONCRETE SURGEONS, INC. In v oice
5705 WEST 73RD STREET
1 INDIANAPOLIS, IN 46278
A IN N. IN ,A 317) 291-0600 822 -3844 FAX (317) 291-0606 0
7/21/2009 25003
BILL To
CARMEL UTILITIES
760 3RD AVENUE SW, STE 110
CARMEL, IN 46032
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S11787 Net 30
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LIFTSTATION 106TH HAZELDELL RD. CARMEL, IN
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CORE DRILLED 34" DIA. HOLES THRU 18" DEEP CONCRETE 495.00 495.00
WALL OUT OF CRANE BASKET
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S4 i Y m N l r t w i t xc r P E R V N T
The Concrete Surgeons
assume no habililty whatso-
ever for layout of wall/ Thank you for y business
floor openings, holes or
lines, or for cutting any
buried electrical, gas or
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water -sewer lines. TOTAL $495.00
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Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
Fd
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
00353052
CONCRETE SURGEONS Purchase Order No.
5705 W. 73RD ST Terms
INDIANAPOLIS, IN 46278 Due Date 7/28/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/28/2009 25003 $495.00
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Q
hereby certify that the attached invoice(s), or bill(s) is (are) true and
orrect and I have audited same in accordance with I 5- 11- 10 -1.6
7 °Z C
Date Officer
VOUCHER 096107 WARRANT ALLOWED
00353052 IN SUM OF
CONCRETE SURGEONS
5705 W. 73RD ST
INDIANAPOLIS, IN 46278
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
25003 01- 7363 -06 $495.00
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Voucher Total $495.00
Cost distribution ledger classification if
claim paid under vehicle highway fund