212021 08/15/2012 CITY OF CARMEL, INDIANA VENDOR: 353974 Page 1 of 1
;� ONE CIVIC SQUARE CASEY-BERTRAM CONSTRUCTION INC CHECK AMOUNT: $39,750.00
CARMEL, INDIANA 46032 5780 E 25TH STREET
INDIANAPOLIS IN 46218 CHECK NUMBER: 212021
CHECK DATE: 8/15/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
659 5023990 1828 39, 750 . 00 1050 . 75
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Invoice
Date Invoice#
6/20/2012 1828
Bill To
Carmel.Waste Water Treat'
reatment Plant
9609 Hazel Dell Parkway
Indianapolis,IN 46280
P.O. No. Terms Due Date Project
513085 30 days 7/20/2012 3253-12 9609 Hazel...
Description Qty Rate Amount
Services provided as pet agreement dated 4/19/12 39,750.00 39,750.00
D��1•a1�d �3�I�t9t�� . -
Thank you for your business!
Total $39,750.00
Payments/Credits
Balance,Due $39,750.00
5780 East 25th Street Indianapolis, Indiana 46218
(317) 546-3366 (317) 546-6680 FAX
VOUCHER # 125191 WARRANT # ALLOWED
353974 IN SUM OF $
CASEY BERTRAM
5780 E 25TH STREET .
INDIANAPOLIS, IN 46218
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
07-Jos'p- 7S
1828 D'F 7-362-A6- $39,750.00
C- I\jj\J6 CJ OV
1
Voucher Total $39,750.00
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
353974
CASEY BERTRAM Purchase Order No.
5780 E 25TH STREET Terms
INDIANAPOLIS, IN 46218 Due Date 6/26/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/26/2012 1828 $39,750.00
i
1
i
hereby certify that the attached invoice(s), or bill(s) is (are)true and
;orrect and I have audited same in accordance with IC 5-11-10-1.6
Date Officer