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Home My WebLink About178573 10/27/2009 a- CITY OF CARMEL, INDIANA VENDOR: 359662 Page 1 of 1 ONE CIVIC SQUARE A T T CUSTOM WORK ORDER CENTER CARMEL, INDIANA 46032 220 WISCONSIN AVE eHECK AMOUNT: $60,344.85 WAUKESHA WI 53186 CHECK NUMBER: 178573 CHECK DATE: 10/2712009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 902 4460847 CR #113089 60,344.85 HEARTHVIEW OLD TOWN 05/0512009 11:49 2629700454 ATT CWD CENTER PAGE 01105 a$ l'hoiie: 885 -61$ -6815 Fax: 88$- 901 -2821 May 5, 2049 Sherry, Mielke City of Carmel 11 1. West Main Street I Carmel, 46032 Fax: 317- 571 -2789 RE CR4113089 P.TT4 6533490 Parcel 47 AT&T Facility Move Sherry Mielke, Enclosed is the Final Statement of Charges Amottnt: $60,344.85 AT &T Federal IDA 134924710. Please forward your payment to AT Invdice As Fait bt e.'� Please use the Customer Request Number (CR oo your correspondence. if you have any questions, please feel free to contact me_ AT &T Enginieer: Steven Krebs (317) 252-42,75 Please forwardpaTment fo AT &T Custom Work Or der Center 220 Wisconsin Avenue Waukesha, W1 53186 Please feel free to contact me 588- 618 -6882. Respectfully, Beth M. Wittimann Customer Contracts Specialist AT&T Custom Work Order Center 4 pages follow 05/05/2009 11:49 2629708454 ATT CWO CENTER PAGE 02/05 AT &T INDIANA Estimate of Cost and Authority for Work A M44 08A Special Construction Charge and Invoice Customer Request Number 113089 Date 07/15/2008 Project Number 6533490 Customer ID 103093 Billing Information Billing Party's Name: CARMEL REDEVELOPMENT COMMISSION PARCEL 47 Phone: (317) 571 2787 Billing Address 111 WEST MAIN STREET SUITE 140 CARMEL, IN 46032 Contact Name SHERRY MIELKE Phone (317) 571 -2787 Work Description RELOCATE AT &T FACILITIES AT 1 ST AVENUE NW TO 2ND AVENUE NW, THIS WORK REQUIRES UPFRONT Engineering Remarks PAYMENT AND SIGNED CONTRACT. PLEASE REMIT PAYMENT TO: 220 WISCONSIN AVENUE, FLOOR 2, WAUKESHA, WI 53186. COST IS VALID FOR 30 DAYS. INVOICE Expenses 1 Amount Engineering Labor 3.317.63 Material Cost 19,898.97 Construction Lab La 9,043.79 Contractor Cost 28,084.46 Misc. Tax $0.00 Total Estimated Costs 60,344.85 OSPE Representative: BE THEL WIT PAST DUE Title: C WO Manager A Phone 888- 618 -6882 l O (L 0- 05/0512009 11:49 26297 08454 ATT CW0 CENTER PAGE 09/05 9 INDIANA RETAIL TAX EXEI pT PAGE Uny of Ua- rme l CERTIFICATE NO. 0037 20155 402 0 I PURCHASE ORDER NUMSEq FEDERAL EXCISE TAX EXEMPT 35- 60DO0972 ONE CIVIC SQUARE THIS NUMBER MUST' APPEAR ON INVOICrS AAA VOUCHER, DEUVERY MEMO, PACKING SLIPS, CARMEL, INDIANA 4,6032.2584 pFiIPPINQ LAIIELS AND ANY CORHFSPONDENCE. FORM APPROVED BY STATE I30ARID Or ACCOUNTS FOR CITY OF CARMEI,. 1997 JRCHAo ORDER DATE DAT REQUIRED REQUI N(7, VENDOA NQ. pE,,,CFi1F'TION 4 IIFNDOR Z b I.,a t c &A.F it SHIP 11( IrJ e /�'�r. n I S., i 1 LAO iNrmr--T,ON I SLAN T CONTRACT PAYMFN7TEAM9 FREIGHT QUANTITY UNIITOFMERSURE D[SCTiIF'TfON UNIT PRIDE €>(T is 5'1 a� ra1x� c1Y�° 4 Send Invoice To c1411r'4e If Ka 1o�.��e..�- j AJ PLEASE INVOICE IN DUPLICATE DEPARTMENT ACCOU PROJECT PRQJEI TA 0OUNT AMOUNT PAYMEN A,P VbU4`ItFti GANN T BE ARhCiOVEO Fnq PAYMENT UNLESS THE P.O. 1�UMF3ER IS MADC A f�AR7 Ot= THE VOUCFIER AND F „Vp_RI' IN711O'CB ANb VOUCHER HA$ THE d SWOAN AFFIQAVITATT'ACHEb. SHIPPING INSTRUCTIONS IHEliEBY FpY TF1AT Tli[RE AN UNOgLIGATED flALANCI IN HI 17P IAi10 aUEf Y j PAY FQRTHEAflOV� DRDER. v_ SHIP REPAID, O O.O.$HIPM €NTG CANNOT AFAC=PTED. ORDER1nD BY PURCHASE OROEA NUMBER MUST APPEAR ON ALL 'f SKIPPING LABELS. ��j T141S ORDER 1650th IN COMPLIANCE WITH rHAPTrR 99, ACTS 1943 TITLE •�fGr_` AND ACts AMENDATOF1r HEAECF AND SUPPLE T T 1 9 8 G 5 CLERK- TREASURER -L DOCUME=NT CONTROL NO. VENDOR COPY 05/05/2009 11:49 2629708454 ATT CWO CENTER PAGE 04105 AT&T INDIANA at &t Estimate of Cost and Authority for Work I s 08 A Special Construction Charge and Invoice Customer Request ivumber 113069 Date 07/15/2008 Project Number 6533490 Customer ID 103093 Work Authorization: I acknowledge that the work described under this agreement is to be completed for my benefit and at my request, I understand that according to the tariffs of Indiana Sell Telephone Company, Incorporated, d /b /a SOC Indiana, an Indiana corpora tion on file with the Indiana Utility Regulatory Commission, or the FCC, as applicable, that it is my responsibility to pay those costs incurred by AT&T INDIANA to complete the work requested, i understand that if I cancel this work auth6ftation subsequent to acceptance, I am responsible for payment of all engineering costs incurred by AT &T INDIANA prior to actual work being performed. I further understand that if changes are required at my request, I will be responsible for any additional costs incurred by AT &T INDIANA after the c estimate(s) have been prepared. k o .4TF4 I understand that I must pFepey the estimated charges as stated on page one (9) of this contract prior to the commencement of any work by AT&T INDIANA, I also understand that if actual charges exceed the estimated costs I will not receive any additional billing unless I have pre authorized the additional billing due to a change requested by me or my representative(s). rat sho lobe in the form of a certified check or money order, payable to AT&T INDIANA. 4 Oate (Print) For Businoss Customers Only Corporations; Agreement must be signed by an officer of the Corporation or Company and attested; or, be accompanied by a certified resolution of the Board Of Directors authorizing execution by an official of the Corporation or Company Partnership: Agreement must be signed by all partners. Municipalities or Governmental Agencies: Agreement must be accompanied by a certified resolution authorizing the official signing the agreement to execute on behalf of the ovemmental Entity. The resolution should hot be certified by the same official signing the executed agreement. Name of Corporation/ Company /Pomership /Govornmental Entity 'r Signature Date (Print) Title IF THIS AGREEMENT IS NOT SIGNED ANb ACCEPTED WITHIN THIRTY (30) DAYS OF THE DATE ON THIS CONTRACT. THE ESTIMATrb CQST,*, A$SOGIATED WITH THIS CONTRACT ARE NULLIFICD AND INVALID. .0510512009 11:49 2629708454 ATT CWD CENTER PAGE 45165 Frain:Urn,ei Redeve].apmenr Cams. 01104/2008 13 :38 #299 P. 0031004 JAM- 04-8Q08 15:10 FRDM:2 2629708453 TO.913175712789 P.081"801 CRO I MOM 1.4.2oLS F`.d," =F.571.2769 oca,te ATW saaBttfes (#3) 10 Ave. NW to 2nd Ave. SW AUTHOMATION TO PREPARE COST BSTI 4 TE I byre m- quested and anthorized AT&T to pre em a deWed coat eatimate aseod.ated vdth ng changos to AT&T's 0�dstix Wet mr'k on my behaE Should. I determine riot to proceed, ura,cc thoso costa hoe be-m calcWatod acid provided, to me, I understend I am responsible for eM w4i neeri,ng rata auaoclated VAth prepar"ng the cast estimate. The s Adpated englneerm. g costs jusaociated with this coat estimate ooWd, r&W mnywhere from $300 $700 (averap range but not 1itialted to), however, T, a,raderstand. I wM be billod far t1e Actual eogirecring time required to develop the umit cattmaw. I fCxnhm a ndderatand that if l proceed. with the =gtiaciAcd, wor1c, the eaimg, chars arc ir�cl,uded as past of thosc oasts. Work aiw information StMgt ad.dresa: II tl�l 7.._ r_st__(RJ� i ts ril rz t {�V �"Q b AV r Vv Np WMAIUvt a� i .7 Kk )rt rod O L Si r�7fid e-T VU City, State, 8a UP; y`` a-A ��'L�11Un O� WQr,� 'Cf. be �Ll.d'I�CS�: t"`��•�f] C:.Q�'4. �rtCc E �.1 o6 C ES rS.t ,�.Nq:7 0.9.3 q 5q Billing infQmaf4 on T� c'L7rmpamy Name! t /p n v Q1 �dP_ L$4Qf�,� L ±rrti��3 1 s nrti Street .Acl4rcas: __'�1.,1 4o s o� r+- CAV, Stage 7. dip: r a L, phrme Numbar(a) for contact: Fax Number fox invoidaag Print Name Sfgn�tua Date: L 4 This doa=ent must be aigmed and, ro=wed before any design vwrk will be con .plated. Once completed pXs oe f9r, or mail ta: Roth Ill. WIt>tMAIM Manager—Custom Work OR40X 00 ater 220 Wisconsin Avenne Mr. 2 Whukesha WI 88 Pa. ass.6119.6882 Fes. 888.901. k82 .Tau A4 -PRMP AF,:797M TEL ID)2 PAGE:003 R `96 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 14'7 El T Purchase Order No. ao�0 (,vtsc.onsln �u�. �Ir. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) 62 (13US 11vc.r_� r�ffl Total (a O j,3 4 4 S 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 4 IN SUM OF L O ��c�i hm tjor(C Orde-r (�cJ t.1 Ccrnsl ,'4"c�c'aL. CIa oT •2._ 1,0 T 53 i5 0 3 qe( F S_ ON ACCODU I OF APPROPRIATION FOR T F ///L Ga y Board Members Po# or INVOICE NO. ACCT #/TITLE AMOUNT DEPT, I hereby certify that the attached invoice(s), or df o Z� f�0,3u•�f"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 20 O 7 Signature Director of Operations Cost distribution ledger classification if Title claim paid motor vehicle highway fund