209094 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 366262 Page 1 of 1
0 ONE CIVIC SQUARE CHANCE FARMS
CARMEL, INDIANA 46032 5420 E 675 N CHECK AMOUNT: $1,378.00
LEBANON IN 46052 CHECK NUMBER: 209094
CHECK DATE: 5/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 100 1,378.00 OTHER EXPENSES
Chance Farms Invoice No. 100
5420 E. 675 N.
Lebanon, IN 46052
I
Customer Misc
Name Carmel Waste Water Treatment Plant Date 4/27/2012
Address 9609 Hazel Dell Parkway Order No.
City Indianapolis State IN ZIP 46280 Rep
Phone (317) 571 -2636 Ext. 210 c/o Teresa Lewis FOB
Qty Des criptio n Unit Pricel TOTAL
424 Yards of Carmel Biosolids for the Month of April 2012 3.25 1,378.00
$5.00 /yard minus ($1.75) yard for Spreader Truck Rental $3.25/ yard
SubTotal 1,378.00
Shipping
Payment I Credit Tax Rate(s)
Comments TOTAL 1,378.00
Name
CC Office Use Only
Expires
Thank You!
Insert Farewell Statement Here
VOUCHER 117356 WARRANT ALLOWED
T0682 IN SUM OF
CHANCE FARMS
5420 E 675 N
Lebanon, IN 46052
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
100 01- 7110 -05 $1,378.00
Voucher Total $1,378.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
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 of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
T0682
CHANCE FARMS Purchase Order No.
5420 E 675 N Terms
Lebanon, IN 46052 Due Date 5/18/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/18/2012 100 $1,378.00
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
Date Officer