212686 09/12/2012 CITY OF CARMEL, INDIANA VENDOR: 00351005 Page 1 of 1
�0 ` ONE CIVIC SQUARE MATTINGLY CONCRETE CHECK AMOUNT: $4,900.00
? CARMEL, INDIANA 46032 15936 JOLIET ROAD
WESTFIELD IN 46074 CHECK NUMBER: 212686
CHECK DATE: 9/12/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 54468767 4, 900 . 00 CONT SERVICES OTHER
Ma ngly Concrete, Inc. Invoice#: 54468767
15936 Joliet Rd. Invoice Date: 8/30/2012
Wes ield, Indiana 46074
317.867.4049 ® 1 ® ® D
INC.
INVOICE
Customer Name &Address:
City of Carmel, Indiana
C/O: 2468 Centennary Drive Carmel, Indiana 46032
Work Completed:
Driveway apron replacement. Included new culvert pipe , sealer, back II, etc.
Total: $4900.00
Down Payment: NA
Balance Due Upon Receipt: $4900.00
THANK YOU!
Prescribed by State Board of Accounts
Form No.3°' (Rev.1995) ACCOUNTS PAYABLE VOUCHER
TO
ADDRESS
Invoice Date Invoice Number Item Amount
I 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
' 19
Signature Title
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.
19
ficer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ACCT.
NO.
CARMEL, INDIANA
AA¢ tis/t( C i,N Favor Of
II J C1'ele
Cucst"{7'eld �/v �/�C�7
Total Amount of Voucher $
Deductions I_
68 7 677 WOO 00 '
1. 6 3:OE6 6
Amount of Warrant $
Month of 19
Acct.
VOUCHER RECORD No.
Source of Supply
Water Treatment
Transmission and Dist.
Customer Accounts
Administrative and General
Operation-Maintenance
Utility Plant in Service
Constr.Work in Progress
Materials and Supplies
Customers Deposits
Total
Allowed
Board of Control
Filed
Official Title
80YCE FORMS.SYSTEMS 1-800-382-8702 325