215630 12/18/2012 CITY OF CARMEL, INDIANA VENDOR: 365731 Page 1 of 1
ONE CIVIC SQUARE FIRST GROUP ENGINEERING
CARMEL, INDIANA 46032 5925 LAKESIDE BLVD CHECK AMOUNT: $9,522.00
INDIANAPOLIS IN 46278 CHECK NUMBER: 215630
CHECK DATE: 12/18/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
206 R4462300 26542 7560-3 9, 522 . 00 ASA#1-WILLIAMS CREEK
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City of Carmel Invoice number 7560-3
Michael McBride Date 11/30/2012
One Civic Square
Carmel, IN 46032 Project 12-7560 STRUCTURE REPLACEMENT
IN CARMEL
in accordance with our Amendment#1 dated August 15, 2012,the following is an invoice for services provided
on ther referenced project to November 30, 2012.
Structure Replacement over Tributary of Williams Creek at Spring Mill Rd, South of 106th St.
Contract Percent Amount Less Prior Amount Due
Description Amount Complete Complete Billings This Billing
SOILS INVESTIGATION 5,000.00 0.00 0.00 0.00 0.00
SURVEY 9,000.00 100.00 9,000.00 9,000.00 0.00
DESIGN AND PERMITS 27,600.00 60.50 16,698.00 7,176.00 9,522.00
Total 41,600.00 61.77 25,698.00 16,176.00 9,522.00
Invoice total 9.522.00
Aging Summary
Invoice Number Invoice Date Outstanding Current Over 30 Over 60 Over 90 Over 120
7560-3 11/30/2012 9,522.00 9,522.00
Total 9,522.00 9,522.00 0.00 0.00 0.00 0.00
Approved by:
41
Randall M.Willing
Executive Vice President
(0�$g10111273
Please remit payments to. First Group Engineering, Inc. 5925 Lakeside Blvd. Indianapolis, IN 46 8.1
RECEIVED .
DEC 2012 co
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City of Carmel Invoice number 7560-3
Page 1 of 2
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 service rendered, by whom,
rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
First Group Engineering, Inc. Purchase Order No.
5925 Lakeside Blvd. Terms
Indianapolis, IN 46278 Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s) Amount
11/30/2012 7560-3 William's Creek and Spring Mill Structure $ 9,522.00
Total $ 9,522.00
1 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.
,20
Clerk-Treasurer
VOUCHER NC WARRANT NO.
First Group Engineering, Inc. ALLOWED 20
5925 Lakeside Blvd. IN SUM OF $
Indianapolis, IN 46278
$ 9,522.00
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITL AMOUNT
DEPT# I hereby certify that the attached invoice(s),
26542 7560-3 206-R4462300 $ 9,52200 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 except
2/20/2012
Signatu a &A'i6--oe(
�1 g G� ®er LD—c S
Cost Distribution ledger classification if Title
claim paid motor vehicle highway fund