213877 10/23/2012 CITY OF CARMEL, INDIANA VENDOR: 366262 Page 1 of 1
ONE CIVIC SQUARE CHANCE FARMS
CARMEL, INDIANA 46032 5420 E 675 N CHECK AMOUNT: $695.50
LEBANON IN 46052
CHECK NUMBER: 213877
CHECK DATE: 10/2312012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 102 695 . 50 SLUDGE REMOVAL EXPENS
Chance Farms Invoice No. 102
5420 E. 675 N.
Lebanon, IN 46052 11INVOICE
Customer Misc
Name Carmel Waste Water Treatment Plant Date 10/4/2012
Address 9609 Hazel Deli Parkway Order No.
City Indianapolis State IN ZIP 46280 Rep
Phone (317)571-2636 Ext. 210 c/o Teresa Lewis FOB
Qty Description Unit Pricel TOTAL
214 Yards of Carmel Biosolids for the time period of 9/12/12-9/13/12 $ 3.25 $ 695.50
$5.00/yard minus($1.75)/yard for Spreader Truck Rental=$3.25/yard
SubTotal $ 695.50
Shipping
Payment Credit Tax Rate(s)
Comments TOTAL $ 695.50
Name
CC# Office Use Only
Expires
Thank You!
f
Insert Farewell Statement Here
VOUCHER # 125891 WARRANT # ALLOWED
T0682 IN SUM OF $
CHANCEFARMS
5420 E 675 N
Lebanon, IN 46052
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
102 01-7110-05 $695.50
Voucher Total $695.50
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board oflAccounts City Form No.201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to t')e 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
T0682
CHANCE FARMS Purchase Order No.
5420 E 675 N Terms
Lebanon, IN 460521 Due Date 10/15/2012
Invoice Invoice;i
Description
Date Number (or note attached invoice(s) or bill(s)) Amount
i
10/15/201; 102 i $695.50
I
I
1
i
hereby certify that the zfittached invoice(s), or bill(s) is (are)true and
correct and I have-audited same in accordance with IC 5-11-10-1.6
Date Officer