180415 12/16/2009 CITY OF CARMFL., INDIANA VENDOR: 00350320 Page 1 of 1
ONE CIVIC SQUARE E B PAVING, INC
CARMEL, INDIANA 46032 286 WEST 300 NORTH CHECK AMOUNT: $9,121.26
ANDERSON IN 46012 CHECK NUMBER: 180415
CHECK DATE: 12/16/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DE SCRIPTION
1110 4350100 21075 209292722 9,121.26 PAVING
Frowkffl Paving Noblesville 317 773 4137 1211112009 10:49 #233 P.001 /001
rr
avi n I nc.
ASPHALT PAVING CONTRACTORS
Invoice 02092927 -22
E B Paving, Inc. Carmel 2009 Paving
17042 Middletown Ave Police Parking Lots
Noblesville, IN 46060
Contact: Steve Varner Contact: Mr. Dave Huffman
Phone: (317) 773 -4132 Phone: 317 733 -200'f
Fax: (317 773 -4137 Pax: 317 733 -2005
Contractual Information
Contract Number. R- E B Job Number. 02092927
Contract Description: SR, E B Superintendent: Bob Pring
Superintendent Phone: 317 -409 -2140
Owner: City of Carmel Superintendent Pager:
Project Engineer: Mr, Dave Huffman Field Office Phone:
ITEM NO. DESCRIPTION QUANTITY1 UNIT UNIT PRICE TOTAL
Increased labor costs 1.00 Lump Sum $1,925.00 $1,925.00
Increased equipment costs 1.00 Lump Sum $1,460.00 $1,460.00
Increased trucking costs 1.00 Lump Sum $515.00 $515.00
2 #11 Surface HAC 100.12 Tons $52.15 $5,221.26
Total $9,121.26
GENERAL NOTES
Prices above reflect actual work and actual quantities performed.
Payment terms are net 30 days upon the date of invoice.
E B PAxLqv, Inc. Carmel 2009 Paving
By: :�2 By:
Title: amer Title:
Project Manager
We Are An Equal Opportunity Employer
17042 MIDDLETOWN AVE NOIXESVILLE, INDIANA 46060 PHONE (317) 773 -4132 FAX (317) 773 -4137
Purchase Order Page 1 of 1
INDIANA RETAIL TAX EXEMPT PAGE C i t y o Carmel CERTIFICATE NO.003120155 002 0 �i PURCHASE ORDER NUMBER
V Police Department FEDERAL EXCISE TAX EXEMPT
35- 60000972 210
31DNE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/P
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
h uftnt 11, 2009 oavin
VENDOR E E Paving, Inc SHIP City of Carmel, Police Department
17042 Middletown Avenue TO 3 Civic Square
Nobiesville, IN 46060 Cammel, IN 46032
CONflaMAT1ON BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
parking lot paving North and South lots 9,121.26
4 s
s
rol
Send Invoice To: V r
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
1110 501 building repairs and mainte0k M T
A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS r I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
THIS APPROPRIA7 N SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
PURCHASE ORDER NUMBER MUST APPEAR ON ALL s
SHIPPING LABELS.
THIS ORDER ISSUED 1N COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE ief of Police
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 P CLERK TREASURER
DOCUMENT CONTROL NO. A.. COPY- SIGN AND RETURN TO CLERK'S OFFICE
VQUCHFR NO.— WARRANT NO.—
ALLOWED 20
IN THE SUM OF
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO# or INVOICE NO, ACCT /TITLE AMOUNT
DEPT E hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except_____
20
Signature..
Title
Cost distribution ledger classification if
claim paid motor vehicle highway 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 service rendered, by
'Whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
E B Paving Inc. Purchase Order No. 21075F
17042 Middletown Avenue Terms
Noblesville, TN 46060 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/11/09 209292722 payment for paying both parking lots 9,121.26
Total
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.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
E B Paiving, Inc. IN SUM OF
17042 Middletown Avenue
Noblesville, IN 46060
9,121.26
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
Pots or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
21075F 209292722 501 9;121.26 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
December 11 20 09
&M'4�—e
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund