172368 05/13/2009 CITY OF CARMEL, INDIANA VENDOR: 141050 Page 1 of 1
ONE CIVIC SQUARE INDEPENDENT CONCRETE PIPE CHECK AMOUNT: $248.40
CARMEL, INDIANA 46032 INDIANA DIVISION
3621 RELIABLE PARKWAY CHECK NUMBER: 172368
CHICAGO IL 60686 -0036
CHECK DATE: 5/13/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
206 4237001 111608 248.40 STORM SEWER MAINT SUP
r,
INDIANA DIVISION 111608 1
2050 S. Harding DATE
Indianapolis, IN 46221
REMIT TO:
Phone: 317-262-4920 INDEPENDENT CONCRETE PIPE CO.
IN DIVISION
3621 RELIABLE PARKWAY
CHICAGO, IL 60686-0036
SOLD CITY OF CARMEL SHIP Street Dept 5/1/09
TO 3400 West 131st Street TO
Westfield IN 46074
32899 05/01/09 1000520____IN�SLH 1__ YOUR TRUCK
ORDER/B.O. SHIP/RETURN ITEM NO.IDESC. UNIT_PRICE Om NET PRICE
__T
6.00 6.00 0 JTMKS 20.0000 EA 120.00
1.00 ROLLS 1 INCH KENT SEAL .00
Ticket 032899-003 6.00 1
4.00 4.00 0 006AR 30.0000 EA� 120.00
1.00 6 ADJUSTING RING .0(D
Ticket 032899-003 4.00
Original Copy
SALES AMOUNT 240.00
COMMENT
SURCHARGE 8.40
FREIGHT .00
TOTAL 248.40
TERMS Net 30 days AMOUNT RECEIVED .00
BALANCE DUE 248.40
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
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
05/01/09 111608 $248.40
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
Independent Concrete Pipe Co.
Indiana Division IN SUM OF
3621 Reliable Parkway
Chicago, IL 60686 -0036
$248.40
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
206 111608 42- 370.01 $248.40 1 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
Thursday, May 07, 2009
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