170583 04/01/2009 CITY OF CARMEL, INDIANA VENDOR: 362334 Page 1 of 1
ONE CIVIC SQUARE SPECIALTIES COMPANY LLC
CHECK AMOUNT: $6,075.00
CARMEL, INDIANA 46032 9350E 30TH STREET
INDIANAPOLIS IN 46229 CHECK NUMBER: 170583
CHECK DATE: 4/1/2009
DEPARTMENT ACCOUNT PO NUMBER INV NUMBER AMOUNT DESCRI
2201 R4350200 18766 8551 6,075.00 HARRISON MONUMENTS
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REMIT TO: INVOICE
Invoice 8551
SPECIALTIES COMPANY, LLC Page No. -1-
Pay
7LL.L 9350 East 30t h Street Application Date Terms Contract
Indianapolis, IN 46229
(317) 594 -0291 Fax (317) 594 -0271 1 1 02 MAR 2009 NET 30 DAYS I PO# 18766
V Specialized for Construction
Contract Location
Customer 1633 I Job Cost Project 79069 I
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CARMEL STREET DEPARTMENT I CARMEL ST. DEPT MONUMENTS I
3400 W. 131ST ST. 1 3400 W. 131ST STREET 1
WESTFIELD, IN 46074 I
WESTFIELD, IN 46074 1
Estimated Previous Current To Date Unit Current To Date
Bid Item Description UOM Quantity Quantity Quantity Quantity Price Amount Amount
1 HARRISON MONUMENT IN EA 9.0000 0.0000 9.0000 9.0000 675.0000 6,075.00 6,075.00
*Total Base Contract 6,075.00 6,075.00
Total Contract And Change Orders 6,075.00 6,075.00
Billing Summary For Contract 79069
Current To Date
Complete To Date 6,075.00 6,075.00
Materials On Hand 0.00 0.00
Sales Tax 0.00 0.00
Less Retainage Per Item 0.00 0.00
Balance 6,075.00 6,075.00
Less Previous Payments 0.00
Total Amount Due 6,075.00 6,075.00
Soil Stabilization V Concrete Breaking o Guardrail V Fencing T Milling V Video Inspection
Finance charge of 1 1 /2% per month (18% annual) will be applied to all past due balances. Reasonable Attorney's fees and court costs will be added.
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))
03/02/09 8551 $6,075.00
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 NCI. WARRANT NO.
ALLOWED 20
Specialties Company, LLC
IN SUM OF
9350 E. 30th Street
Indianapolis, IN 46229
$6,075.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO# Dept. INVOICE NO. ACCT /TITLE AMOUNT Board Member:
18766 8551 43- 502.00 $6,075.00 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
�riflay, arch 27, 200E
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Street Commiss (o r
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Cost distribution ledger classification if
claim paid motor vehicle highway fund