213508 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 141050 Page 1 of 1
ONE CIVIC SQUARE INDEPENDENT CONCRETE PIPE
CARMEL, INDIANA 46032 INDIANA DIVISION CHECK AMOUNT: $335.34
t� PO BOX 2847 CHECK NUMBER: 213508
OH` INDIANAPOLIS IN 46206-2847
CHECK DATE: 10/9/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 ARSIO000775 335 . 34 OTHER EXPENSES
DENT cpgr�9 Independent Concrete Pipe I nvoice
��c• E� 2050 South Harding Street Number .................:ARS100007752
Indianapolis,IN,46221 Date .....................: 9/21/2012
.o Page ....................: 1 of 1
Telephone : 317-262-4920 Sales order ..............: S00005217
Fax ........: 317-262-8011 Customer PO ...........: PO#S-13252
Sales rep ................: Sandy Hulet
Payment terms ..........: Net 30 days
Invoice account .........: IN0095
Customer Contact .......:
Job description ..........: Blane Mallaber
Sold to Ship to:
City Of Carmel City Of Carmel
9609 Hazel Dell Parkway Blane Mallaber
indianapollis, IN 46280
Item number Wall Class Description Unit Quantity Unit price Amount
Packing slip: 00014404 Ship date: 9/21/2012
002 AR 2"Adjusting Ring Each 10.00 18.00 180.00
004 AR 4"Adjusting Ring Each 6.00 24.00 144.00
Surcharge 3.50
Terms: Net 30. After expiration of this term, customer shall pay 8% Remit To Sales balance ... 324.00
interest, costs of collection, and attorney fees. Independent Concrete Pipe CoMisc. charges ... 11.34
P.O. Box 2847 Sales tax .......: 0.00
Indianapolis, IN 46206-2847 Total 335.34
VOUCHER # 125787 WARRANT # ALLOWED
141050 IN SUM OF $
INDEP CONCRETE PIPE CO
PO BOX 2847
INDIANAPOLIS, IN 46206-2847
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
ARS10000775 01-7200-02 $335.34
Voucher Total $335.34
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
141050
INDEP CONCRETE PIPE CO Purchase Order No.
PO BOX 2847 Terms
INDIANAPOLIS, IN 46206-2847 Due Date 10/1/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/1/2012 ARS1000077! $335.34
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
1 v/d/ L c�'---e Date Officer Officer