209999 06/20/2012 CITY OF CARMEL, INDIANA VENDOR: 00352077 Page 1 of 1
ONE CIVIC SQUARE FLUID WASTE SERVICES INC
CARMEL, INDIANA 46032 PO Box 264 CHECK AMOUNT: $618.75
o NOBLESVILLE IN 46061 CHECK NUMBER: 209999
CHECK DATE: 6/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 5643 618.75 CONT SERVICES OTHER
Fluid Waste Services, Inc. Inv oice
P. O. Box 264
Noblesville, IN 46061 Date Invoice
317 773 -7996
6/6/2012 WO -5643
Bill To
City of Carmel Water Utilities
3450 W. 131 st St.
Westfield, IN 46074
US
P.O. No. Terms Project
2038 Due on receipt 2810 E 116TH STR...
Description Qty Rate Amount
WEDNESDAY 6/6/12
CONTACT: GREG HOLLANDER 650 -2524
AND JERRY SMITH 650 -5582
SITE: 2810 E 116TH STREET
CREW: JD /GM
UNIT: C -22
VAC EXCAVATE AS DIRECTED.
WATER DISPOSAL PROVIDED
MOBILIZATION DEMOBILIZATION 0.5 225.00 112.50
JET AND VAC WITH COMBINATION CLEANING TRUCK 2.25 225.00 506.25
TERMS NET 30
,S% LATE FEE A ����YS
Thank You for Your Business.We accept Visa MC Discover.Please reference Inv. No. On
Remittance Total $618.75
Payments /Credits $0.00
a7lance Due $618.75
VOUCHER 121188 WARRANT ALLOWED
352077
IN SUM OF
FLUID WASTE SERVICES
P. O. BOX 264
FISHERS, IN 46038
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
5643 01- 6360 -06 $618.75
5.
I
j
0
Voucher Total $618.75
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
352077
FLUID WASTE SERVICES Purchase Order No.
P. O. BOX 264 Terms
FISHERS, IN 46038 Due Date 6/12/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/12/2012 5643 $618.75
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
4 115 11
Date Officer