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178310 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 358820 Page 1 of 1 ONE CIVIC SQUARE NOBLESVILLE LANDFILL CARMEL, INDIANA 46032 1601 S 8TH STREET CHECK AMOUNT: $25.00 NOBLESVILLE IN 46060 CHECK NUMBER: 178310 CHECK DATE: 10/14/2009 DEPARTMENT ACC P O NUM INVOICE N UMBER AMOUNT DESCRIPTION 2201 4350100 11527 25.00 BUILDING REPAIRS MA rye Nob2 VROHe 09/30/2009 11527 Due on receipt BILL�TO k Carmel Street Department 3400 W 131 st Street Westfield, IN 46074 Date P�oduct�' ;�fTicket/T�uck Number fry Quantity Rates Amount.` ,u.. 09/18%2 .....�r ,..r 009 k6ad Ki1l:Deer 52206 TK 56 1 25.00 l 25.00 SUBTOTAL $25.00 TAX (7 $0.00 1801 S. 8 Street Noblesville, IN 46060 317 770 -8155 Fax 317- 770 -8999 ®b L an d fill vi lle 52206 Inc Phone: Date: JOE NAME: Type of Truck Pick up /small trailer Semi -dump Single axle /large trailer 20 yd dump box Tandem axle 40 yd dump box Tri axle U,-Other CIRCLE ONE: e'p l' m Fill Dirt Other c e an P- Gravel C F Top Soil, unpulverized Top Soil, pulverized OF LOADS IN: f 1 OF LOADS OUT: 0 Driver's Signature %,K�,?�� Truck REMIT TO: R.E. FR ASH 1801 S. 8th STREET NOBLESVILL E, IN 46060 (317) 770-8155 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)) 09/30/09 11527 $25.00 1 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. WARRA NO. ALLOWED 20 Noblesville Landfill IN SUM OF 1801 S. 8th Street Noblesville, IN 46060 $25.00 ON ACCOUNT OF APPROPRIATION FOR Carmel Street Department PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members 2201 11527 43- 501.00 $25.00 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 Fla O r 09, 2009 Street Commiss4n4 Title Cost distribution ledger classification if claim paid motor vehicle highway fund