205391 01/17/2012 CITY OF CARMEL, INDIANA VENDOR: 00352914 Page 1 of 1
ONE CIVIC SQUARE AMERICAN INDUSTRIAL SERVICES
CHECK AMOUNT: $531.80
CARMEL, INDIANA 46032 8500 GEORGETOWN ROAD
s�.,�~•r• INDIANAPOLIS IN 46268 CHECK NUMBER: 205391
CHECK DATE: 1/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1W1059A 531.80 OTHER EXPENSES
INVOICE
8500 Georgetown Road
f
Indianapolis, IN 46268
Phone: (317)871 -4090
1 Fax: (317)871 -4094
TOLL FREE 1- 800. 877.4955
INVOICE NO: 1WI059A
INVOICE DATE: 12/31/2011
CLIENT:
PROJECT INFORMATION
PROJECT ID:
MR. JOHN DUFFY DESCRIPTION: ROLL OFF DISPOSAL
CITY OF CARMEL UTILITIES LOCATION:
760 3RD AVENUE SOUTHWEST
CARMEL, IN 46032
CONTRACT NO S07574
CONTACT: BILL KELLAM PROJECT NIGR: GREG SPEARS
WORK PERFORMED THRU: 12/27/2011
WASTE MANAGEMENT SERVICES
DESCRIPTION UNIT QUANTITY PRICE /UNIT TOTAL
DISPOSAL (LANDFILL ROLL OFF BOX) 5.53 60.00 331.80
TRANSPORTATION 1.00 200.00 200.00
0
TOTAL
INVOICE 531.80
TERMS: NET 30 DAYS
LATE PAYMENTS WILL BE CHARGED INTEREST AT 1.5% PER MONTH
REMIT PAYMENT TO: AMERICAN INDUSTRIAL SERVICES, 8500 GEORGETOWN RD, INDIANAPOLIS, IN 46268 -1647
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
00352914
AMERICAN INDUSTRIAL SERVICES Purchase Order No.
8500 Georgetown Road Terms
Indianapolis, IN 46268 Due Date 12/30/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/30/201' 1 W 1059A $531.80
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
Date Officer
VOUCHER 116575 WARRANT ALLOWED
00352914 IN SUM OF
AMERICAN INDUSTRIAL SERVICES
8500 Georgetown Road
Indianapolis, IN 46268
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
1W1059A 01- 736H -08 $531.80
Voucher Total $531.80
Cost distribution ledger classification if
claim paid under vehicle highway fund