215159 12/04/2012 a- CITY OF CARMEL, INDIANA VENDOR: 366093 Page 1 of 1
ONE CIVIC SQUARE REPUBLIC WASTE SERVICE-TRASH COMCK AMOUNT: $79,841.60
CARMEL, INDIANA 46032 ATTN:NANCY COLLINS
w ion 832 LANGSDALE AVE CHECK NUMBER: 215159
INDIANAPOLIS IN 46202-1150
CHECK DATE: 12/4/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 79, 841 . 60 OTHER EXPENSES
Republic Services
832 Langsdale Ave
Indianapolis, IN 46202-1150
ATTN: Nancy Collins
Account# 3-0761-9761020
$$$$ Collected By Carmel Utilities
Nov 19 to Nov 30 $ 82,170.60
Less Administrative Fee
9316 Payments $ (2,329.00)
Payment to Republic $ 79,841.60
Prescribed by State Board of Accounts
Form No.301(Rev.1995) ACCOUNTS PAYAB� 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 ex pt
4 c 3
Sig ature Title
I hereby certify that the attached invoice(s), or bill(s), is (are)true an correct and I have audited same in accordance
with IC 5-11-10-1.6.
, 19
fi r Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ACCT.
CARMEL, INDIANA NO.
3G(o� Favor Of
�3;L L,oNUS Da"c -4
A7714 ',
Total Amount of Voucher $
Deductions
Amount of Warrant $
Month ofI 2
I
Acct.
VOUCHER RECORD No.
Source of Supply 1
Water Treatment
I
Transmission and Dist.
Customer Accounts
Administrative and General
Operation-Maintenance
Utility Plant in Service
Constr.Work in Progress
Materials and Supplies
Customers Deposits
1
Total
Allowed I
I
�I
Board of Control
Filed
Official Title
BOYCE FORMS•SYSTEMS 1-800-382-8702 325