213824 10/22/2012 CITY OF CARMEL, INDIANA VENDOR: 366093 Page 1 of 1
1 � ONE CIVIC SQUARE REPUBLIC WASTE SERVICE-TRASH COMCK AMOUNT: $80,508.76
®. CARMEL, INDIANA 46032 ATTN.NANCY COLLINS
832 LANGSDALE AVE CHECK NUMBER: 213824
INDIANAPOLIS IN 46202-1150
CHECK DATE: 10/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 10/8-10/21 80, 508 . 76 CARMEL UTILITIES
Republic Services
832 Langsdale Ave
Indianapolis, IN 46202-1150
ATIN: Nancy Collins
Account# 3-0761-9761020
$$$$ Collected By Carmel Utilities
Oct 8 to Oct 21 $ 82,502.26
Overage Stickers (100 @ $2.50) $ 250.00
Cart Deliveries-September $ 95.00
Less Administrative Fee
9354 Payments $ (2,338.50)
Payment to Republic $ 80,508.76
Prescribed by State Board of Accounts
Form No.301 (Rev.1995) ACCOUNTS PAYABLE VOUCHER /
To
ADDRESS-'>g La,.,os&a�, A,(- 4
Invoice Date Invoice Number bc Item Amount
v 1i-as a �
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 receiv except
�1 19
igna ure Aa 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
Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
No.
MUNICIPAL WATER DEPT. ( ^
NO.
CARMEL, I DIANA
/477i-J:" N-CAW Cy
Total Amount of Voucher $
Deductions
0sob
��11 ct
Amount of Warrant
Month of v\19
VOUCHER RECORD Acct.
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
BOYCE FORMS•SYSTEMS 1-800-382-8702 325