205829 01/31/2012 \,f CITY OF CARMEL, INDIANA VENDOR: 357899 Page 1 of 1
ONE CIVIC SQUARE F K CONSTRUCTION INC
CARMEL, INDIANA 46032 2055 W 150 S CHECK AMOUNT: $45,308.08
FLORA IN 46929
CHECK NUMBER: 205829
CHECK DATE: 1/31/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
612 5023990 8 45,308.08 1050.74
CONSTRUCTION PROJECT INVOICE
DATE: September 29, 2011
COMPANY NAME: F K Construction, Inc.
AND ADDRESS 2055 W. 150 S.
Flora, IN 46929
TELEPHONE NO.: (574)- 967 -4543
FAX NO.: (574)- 967 -3934
PROJECT NAME: 106 Street Path from Westfield Boulevard to Keystone Parkway
PROJECT NO.: 09 -09
INVOICE NO.: 8
Construction pay items as per Progress Pay Estimates No. 8 as shown on the
attached invoice for work completed between the dates of August 1, 2011 to August 31,
2011.
TOTAL PAY THIS ESTIMATE: $120,089.55
Release 9% Retainage: H
TOTAL NOW DUE:
J
Submitted by CrossRoad Engineers, PC 4
P p roject Represent ttive signed name Oate
Lance Stahley
Project Representative printed name
Prescribed by State Board of Accounts
Form No. 301(Rev.1995) ACCOUNTS PAYABLE VOUCHER
TO
ADDRESS
Invoice Date Invoice Number Item Amount
J
fR
F�
I 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
19
Signature Title
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.
19
ficer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE I DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ACCT.
CARMEL, INDIANA
F f Favor Of
K ('ONSfQUC f,i9A-�
cos s Z�b 1 svS
Total Amount of Voucher i
Deductions
5
i
Amount of Warrant 1
i
Month of 19
VOUCHER RECORD Acct.
No. i
Source of Suppl
Water Treatment
Transmission and Dist.
Customer Accounts
Administrative and General
Operation- Maintenance
a
r
Utility Plant in Service
Constr. Work in Progress
Materials and Supplies
Customers Deposits
i
Allowed
Board of Control
Filed
i
Official Title
BOYCE FORMS •SYSTEMS 1-800-382-8702 325
I