172959 05/27/2009 f CITY OF CARMEL, INDIANA VENDOR: 358820 Page 1 of 1
ONE CIVIC SQUARE NOBLESVILLE LANDFILL CHECK AMOUNT: $75.00
CARMEL, INDIANA 46032 1801 S 8TH STREET
NOBLESVILLE IN 46060 CHECK NUMBER: 172959
CHECK DATE: 5/2712009
DEPARTMENT AC COUNT PO NUMBER INVOICE NUMBER AMOUNT D
2201 4350100 11059 75.00 BUILDING REPAIRS MA
Nob Vn 0 fle
andffl Enc
IJATE_`: INVOICE
05/15/2009 11059
TERMS
1! Due on receipt
F p
BILL TO-
Carmel Street Department
3400 W 131 st Street
Westfield, IN 46074
Product T- icket/Truck Number uantity Rate Amoun
05/05/2009 Road Kill:Deer 49783 TK 16 1 25.00 25.00
05/08/2009 Road Kill:Deer 49831 TK 52 1 25.00 25.00
05/11/2009 Road Kill:Deer 49874 TK 17 1 25.00 25.00
SUBTOTAL $75.00
TAX (7%)j $0.00
TOTAL 575.00'
1801 S. 8' Street Noblesville, IN 46060
317 770 -8155 Fax 317- 770 -8999
..e
N ®b L em e 49783
andfi ll Inc Lg e-,
Phone:
Date:
DOB 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 O,-6ther
n
CIRCLE ONE: �'l v'-> r k')
ump Fee Fill Dirt Other
Screene Sand P- Gravel C F
Top Soil, unpulverized Top Soil, pulverized
OF LOADS BIB: l
OF LOADS OUT:
D river's Signatur
Truck f4v
RENT TO: R.E. FRASH
1801 So Oth STREET
NOBLESvOL E, N 46060
(31 7) 770'-81
No esvi le 49831
Phone:
Date:
.DOB 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 C�Ot
CIRCLE ONE:
Dump Fee Fill Dirt Other
Screened Sand P- Gravel C F
Top Soil, unpulverized Top Soil, pulverized
OF LOADS IVY:
OF LOADS OUT
Driver's Si natur
Track
RENT TO: R.E. FR ASH
1801 S. 84h STREET
NOBLESV@ LLE, W 46060
(3b 7) 770-8155
No b L an vl e 49874
R1 Rnc
Phone:
JOB NAME: j V't'e_.C"_ w Date:
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 Othe
CIRCLE
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
Truck
RENT TO: R.E. fFRASH
��np
1 fC S. 8 pp t np h ST f� f np [�E
A
MOBLESF LL LE, W 45050
(3b 7) 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))
05/15/09 11059 $75.00
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 Treasu rer
VOUCHE N WAR NO.
ALLOWED 20
Noblesville Landfill
IN SUM OF
1801 S. 8th Street
Noblesville, IN 46060
$75.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT
Board Member:
2201 11059 43- 501.00 $75.00 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
Th64day, May 21, 200
Street Commissioner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund