215670 12/18/2012 CITY OF CARMEL, INDIANA VENDOR: 141050 Page 1 of 1
ONE CIVIC SQUARE INDEPENDENT CONCRETE PIPE
y� CARMEL, INDIANA 46032 INDIANA DIVISION CHECK AMOUNT: $1,242.00
PO BOX 2847 CHECK NUMBER: 215670
INDIANAPOLIS IN 46206-2847
CHECK DATE: 12/18/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 ARSIO000984 1, 242 . 00 OTHER EXPENSES
I copC9 Independent Concrete Pipe Invoice
�JF 2050 South Harding Street Number ..... ............ ARS100009849
Indianapolis,IN,46221 Date .....................: 11/30/2012
Page ....................: 1 of 1
Telephone : 317-262-4920 Sales order ................ S00005217
Fax ........: 317-262-8011 Customer PO .............
Customer number .......: IN0095
Sales rep ................: Sandy Hulet
Mode of delivery ........: Cust
Payment terms ............ Net 30 days
Invoice account .........: IN0095
Customer Contact .......
Job description ..........: Manhole Repair 12/3/12
Sold to Ship to:
City Of Carmel City Of Carmel
3400 W. 131 st Street
Westfield, IN 46074
US
Item number Wall Class Description Unit Ouantitv Unit price Amount
Packing slip: 00018368 Ship date: 12/3/2012
Kent Seal Kent Seal- Indy Each 60.00 20.00 1,200.00
Surcharge 3.50
Terms: Net 30. After expiration of this term, customer shall pay 8% Remit To Sales balance ... 1,200.00
interest, costs of collection, and attorney fees. Independent Concrete Pipe CoMisc. charges ... 42.00
PO Box 2847 Sales tax .......: 0.00
Indianapolis, IN 46206
Total ............: 1,242.00
VOUCHER # 126340 WARRANT # ALLOWED
141050 IN SUM OF $
INDEP CONCRETE PIPE CO
PO BOX 2847
INDIANAPOLIS, IN 46206-2847
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
ARS10000984 01-7200-02 $1,242.00
Voucher Total $1,242.00
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
141050
INDEP CONCRETE PIPE CO Purchase Order No.
PO BOX 2847 Terms
INDIANAPOLIS, IN 46206-2847 Due Date 12/12/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/12/201; ARS1000098, $1,242.00
hereby certify that the attached invoice(s), or bill(s) is (are) true and
orrect and I have audited same in accordance with IC 5-11-10-1.6
Date Officer