215425 12/11/2012 CITY OF CARMEL, INDIANA VENDOR: 366611 Page 1 of 1
ONE CIVIC SQUARE TCB FARMS
CARMEL, INDIANA 46032 202 E.COLONIAL ST CHECK AMOUNT: $1,488.50
o� PO Box 28 CHECK NUMBER: 215425
KEMPTON IN 46049
CHECK DATE: 12/11/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 102 1, 488 . 50 SLUDGE REMOVAL EXPENS
Kempton Grain&Supply 765-947-5103 p.2
202 E Colonial St., PO BOX 28
Kempton, IN 46050 765-947-7019
SOLD TO:
Carmel Waste Water Treatment Plant INVOICE NUMBER 102
9609 Hazel Dell Parkway INVOICE DATE December 3, 2012
Indianapolis, IN 46280 OUR ORDER NO.
YOUR ORDER NO.
TERMS
SLAPPED TO: SALES REP
Same SHIPPED VIA
F.O.B.
PREPAID or COLLECT
Sales Tax Rate:
QUANTITY DESCRIPTION UNIT PRICE AMOUNT
458 Yards of Carmel Blo-Solids for the month of of November 2012 3.25 $1,488.50
$5.00 1yard minus($1.75/yard for Spreader Truck Rental=$3.25/yard
SUBTOTAL 1,488.50
TAX
FREIGHT
$1,488.50
DIRECT ALL INQUIRIES TO: MAKE ALL CHECKS PAYABLE TO: PAY THIS
Carrie Boyer TCB Farms LLC AMoUN-r
765-947-7019
tmb4d1(&aol.com 242 E Colonial St
Kempton, IN 46049
THANK YOU FOR YOUR BUSINESS!
VOUCHER # 126263 WARRANT # ALLOWED
366611 IN SUM OF $
TCB FARMS
202 E. COLONIAL ST.
PO BOX 28
KEMPTON, IN 46049 i
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
102 01-7110-05 $1,488.50
I
Voucher Total $1,488.50
c
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
366611
TCB FARMS Purchase Order No.
202 E. COLONIAL ST. Terms
PO BOX 28 Due Date 12/4/2012
KEMPTON, IN 46049
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/4/2012 102 $1,488.50
iereby certify that the attached invoice(s), or bill(s) is (are)true and
)rrect and I have audited same in accordance with IC 5-11-10-1.6
Date Officer