177782 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 358820 Page 1 of 1
ONE CIVIC SQUARE NOBLESVILLE LANDFILL CHECK AMOUNT: $50.00
2a CARMEL, INDIANA 46032 1801 S 8TH STREET
NOBLESVILLE IN 46060 CHECK NUMBER: 177782
CHECK DATE: 9/29/2009
DEP ARTMENT ACCOU PO NUMBER INVOICE NUM AM OUNT DESCR IPTION
2201 4350100 11499 50.00 BUILDING REPAIRS MA
(Ilk
�'1
ISO esvi 5 2070
Lan dfill Inc �e
?Phone:
Date:
JOE NAME:
Type ®f Truck
Pick up /small trailer Semi -dump
Single axle /large trailer 20 yd dump box
Tandem axle 40 yd dump box
Tri axle Other
CIR E:
Dum Fill Dirt Other
Screened Sand P- Gravel C F
Top Soil, unpulverized Top Soil, pulverized
OF LOADS IN:
OF LOADS OUT-
Driver's Signature
True
REMIT TO: R.E. FRASH
1801 S. 8 th STREET
NOBL ESVIL LE, IN 46060
(317) 770-8155
N ®b L andfill vi lle 52131
Inc m o61
C (D-r me f si p e s o l
Phone:
Date: L f 0
JOB NAME:
Type ®f Truck
Pick up /small trailer Semi -dump
Single axle /large trailer 20 yd dump box
Tandem axle 40 yd dump box
Tri axle 8} bier
CIRCLE ONE: Op—
m Fee Fill Dirt Other
Scree P- Gravel C F
Top Soil, unpulverized Top Soil, pulverized
OF LOADS oil:
OF LOADS OUT-
Driver's Signature
Truck S S
REMIT TO: R.E. FRASH
9 301 S. 8th STRE
NOBLESVILLE, IN 46060
(31 7) 770-8155
Nob ��Vnfe
DATE INVOICE
09/15/2009 11499
`.TERMS
Due on receipt
BILL TO
Carmel Street Department
3400 W 131 st Street
Westfield, IN 46074
Date Product Ticket/Truck Number Quantity.. Rate Amount
09/09/2009 Road Kill 52070 TK 55 1 25.00 25.00
09/14/2009 Road Kill:Deer 52131 1 25.00 25.00
SUBTOTAL $50.00
TAX (7 $0.00
TOTAL $50.00
1801 S. 8 Street Noblesville, IN 46060
317- 770 -8155 o Fax 317- 770 -8999
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))
09/15/09 11499 $50.00
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. WARRANT NO.
ALLOWED 20
Noblesville Landfill
IN SUM OF
1801 S. 8th Street
Noblesville, IN 46060
$50.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Members
2201 11499 43- 501.00 $50.00 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
hursday, Sep er 24, 2009
J
Street Commiss.oper
I
treet `°''Tlfle`'s oner
Cost distribution ledger classification if
claim paid motor vehicle highway fund