213657 10/09/2012 CITY OF CARMEL, INDIANA VENDOR: 290050 Page 1 of 1
0 ONE CIVIC SQUARE SOUTHSIDE LANDFILL INC CHECK AMOUNT: $339.16
CARMEL, INDIANA 46032 2561 KENTUCKY AVE
PO BOX 421667 CHECK NUMBER: 213657
INDIANAPOLIS IN 46242-1667
CHECK DATE: 10/9/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 SS017830 339 . 16 OTHER EXPENSES
— iCM1 rirnr RCIURIV IVY rum IIVIV vviin TVVR rmjivICIV I inImnamc-
DOCUMENT DOCUMENT TRANS. WASTE UNIT REFERENCE CHARGES CREDITS BALANCE
DATE NUMBER TYPE CLASS
08/31/12 SS017573 Sale 339.16 339.16
Current Period Totals: 0.00
G
pOLA J
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CURRENT OVER 30 DAYS OVER 60 DAYS OVER 90 DAYS OVER 120 DAYS NEW BALANCE TOTAL DUE.
0.00 339.16 1 0.00 0.00 0.00 339.16 339.16
Invoice Closing Date: 09/30/2012 Make Checks Payable To: South Side Landfill,Inc.
—A 1-1/2%SERVICE CHARGE(18%PER ANNUM)WILL Remit To: 2561 Kentucky Avenue
BE CHARGED MONTHLY ON ALL PAST DUE BALANCES P.O. BOX 421667
STARTING WITH A$5.00 MINIMUM CHARGE- Indianapolis, Indiana 46242-1667
VOUCHER # 125855 WARRANT # ALLOWED
290050 IN SUM OF $
SOUTHSIDE LANDFILL INC .
2561 KENTUCKY AVE
PO BOX 421667
INDIANAPOLIS, IN 46242-1667
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR y
Board members
PO # INV# ACCT# AMOUNT Audit Trail Code
SS017830 01-7360-02 $339.16
Voucher Total $339.16
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
290050
SOUTHSIDE LANDFILL INC Purchase Order No.
2561 KENTUCKY AVE Terms
PO BOX 421667 Due Date 10/4/2012
INDIANAPOLIS, IN 46242-1667
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/4/2012 SS017830 $339.16
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