HomeMy WebLinkAbout216028 01/09/2013 CITY OF CARMEL, INDIANA VENDOR: 00351591 Page 1 of 1
s ONE CIVIC SQUARE FIFTH THIRD BANK
CARMEL, INDIANA 46032 38 FOUNTAIN SQUARE PLAZA CHECK AMOUNT: $31,800.00
CINCINNATI OH 45202 CHECK NUMBER: 216028
QOM�
CHECK DATE: 1/9/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
610 5023990 EASEMENT 31, 800 . 00 EASEMENT
• i ,
i
Form..Y.1�'9 I Request.for.Taxpayer Give Form to the
-
(Rev.December 2011) requester.Do not
Depar�r,entofti,eT Identification Number and-Certifcation
reasury send to,the IRS.
'internal Revenue Service:
Name(as shown on youninconie tax return)
N Business name/disregarded entity name,if different frorh above
m
CO
9-' Check. appropriate box for federal tax c i ification:
IndividuaVsole'proprieto� C Corporation Corporation ❑ Partnership ❑Trust/estate
CL 0
C ❑ lJmited.liability comps .Enter the tax classification(C=C corporation,S=S corporation,P.partr*rship)► ❑ � -
Pay.
-------------------------------
a ❑ Other(see instructions);►
Address-(nun ,street,and.apt:or suite no.) - Requesters name and address(optionaQ
m
Q.
M City,state,and ZIP cod
CD
List account num s)here( ptic Gal
Taxpayer:Idelirtification:Number(T.IN)..
Enter your Win the;appropriate`box.The TIN provided'musYmatch the name given on the"Name!'line. Sociat.security number•
to avoid backup withholding.For individuals;this is your social security,number.(SSN).However,for a
resident alien,sole proprietor,,orldisregarded,entity,see the PartI instructions on:page 3.For other.
entities,it-is,your employer.identification number(EIN).If you do not have a number,see How,to get a —m.
TIN:on page 3.
Not a.If the account is in more t an one name,see the chart on page 4 for guidelines on whose Employer identification number
number to enter.
Certification
Under penalties of perjury.,I certifythat:
1. The number shown on this font is my correct taxpayer identification number(or I am waiting for a number to be issued to mej;and
2. 1 am not subject to backup withholding because:(a)I am exempt-from backup withholding,or(b)I.have not been notified by'the Internal•Revenue.
Service(IRS)that l am:subject to backup.withholding as a result of a failure to report-all interest or dividends,or(c)the IRS has notified me that I,am
'no longer subject.to backup:i ithholding,and
3. lam a U.S.citizen or other U.S.person(defined below).
-Certification instructions.You must cross out item 2.above If you have been notified:by the IRS that you-are currently subject backup withholding
because you.have failed to report all interest and dividends on your tax retu :Forreal estate transactions,item 2.does.not apply.For mortgage-
'interest paid,acquisition orab ortm8it red property at of t,contributions to an individual retirement arrangement(IRA),and
generally,payments oth an iriferest and divider yo a not r sign the certification,but you-must provide your correct TIN.Seethe s
instructions on page 4!
Sign. signature of
Here M&person 0- ;I Date Or
Cienera�..�tIStYUC O, Note.If,a requester gives you a form other than Form W-9 to request
your TIN,.you_must use.the requester's form it is substantially similar.
Section references are to the Int I Revenue Code unless otherwise to this Form:W-9.
noted:
beflnition of a U.S..person.,For federal tax purposes,you are
PUrpOSe of Form considered a-U.S.person if you are:
A person who is required to file an information return with the IRS must' •-Ap individual who is a U.S.citizen or U:S.resident alien,
obtain your correct taxpayer identification number(TIN)to:report;for •A,Partnership,corp motion,company,or association created or
example,income paid to you,real estate transactions,mortgage,interest organizedinthe United States or under.the laws of the United States,- -
-you paid,acquisition or abandonment of secured property,cancellation .An estate(other than a foreign estate),or.
of debt,or contributions you.made,to an,IRA.-
Use Form W-9 only rf ou are a U.S. A domestic trust(as defined:in Regulations section 301..7701-7).
y' y person(including a resident
alien);,to provide your correct TIN-to the:person_requesting it(the Special rules for partnerships.Partnerships that conduct a trade or
requester)and,when applicable,Ito:` business in the United States are generally required to pay,a withholding
tax on any foreign partners'.share of income from such business.
' 1.Certify that the TIN you are giving is correct(oryou are waiting-fora Further,in certain cases where a Form W-9 has not been received,a
number to,be.isstied), partnership.is required to Presume that-a,partner is!a foreign.
Person,
2.Certify that you are not subj I ct to backup withholding,or and pay the withholding tax.Therefore,if you are:a,U.S.person'that.is a
3:Claim exemption from backp-withholding.if you,are a U.S.exempt partner in.a partnership conducting-a•trade or business in the United
payee.If applicable,.you are also certifying:that as a U.S.person;your .States,provide Form_W-9 to the partnership to.establish.your U:S.
allocable`share.of any partnership income'from a U.S.trade or business status and avoid withholding on.your share of partnership-incorne.,
is not subject-to the withholding tax on foreign partners'"share,of
effectively`connected income. .
Cat No.10231X Form.W'9(Rev.12-2011)
i
I
Prior Deed References:
Instrument#200200022424 in the
Recorder's Office for Hamilton
County,Indiana
WATER LINE EASEMENT AGREEMENT c
This Water Line Easement Agreement (the "Agreement") is made and entered into this day
of , 2012, by and between Fifth Third Bank, Indiana (Central) ("Grantor") and the City of
Carmel, Indiana("Grantee").
RECITALS:
A. Grantor is the owners of certain real property located in Hamilton County, Indiana
("Grantor's Propert y")more particularly described in Exhibit 1 attached hereto and incorporated herein.
B. Grantee, in connection with Grantee's improvement/construction of the Michigan Road
Water Main Installation —Retail Parkway to 106th Street (the "Project") requires a permanent, exclusive
easement over, through, under, upon and across that portion of Grantor's Property more particularly
described and depicted on Exhibit A and Exhibit B attached hereto and incorporated herein, (the
"Easement Property") to provide for the laying, installing, constructing, maintaining, operating,
inspecting, altering, repairing, replacing and removing water utility lines, and all associated valves,
pumps, fittings,meters, accessories and equipment on, over, and across the Easement Property.
NOW, THEREFORE, for and in consideration of the foregoing recitals which are incorporated
herein by reference and the mutual covenants and agreements hereinafter set forth and other good and
valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the parties agree as
follows:
1. Grant of Easement. Grantor hereby grants and conveys to Grantee an exclusive, perpetual
easement for the purpose of laying, installing, constructing, maintaining, operating, inspecting, altering,
reparing, replacing and removing water utility lines, and all associated valves, pumps, fittings, meters,
accessories and equipment (the "Improvements") on, over, through, under, upon and across the Easement
Property. Grantee shall have the right to: (a) subject to Section 2, remove from the Easement Property
any fences, structures, asphalt or concrete paving, curbing or other improvements, trees, bushes, earth
berming, landscaping and other structures that exist prior to, at the time of, or after Grantee's acquisition
of such easement; and (b) make such alterations and improvements to the Easement Property as Grantee
deems may be necessary or useful in the exercise of Grantee's rights hereunder. If the Improvements are
installed in good faith in a location other than the location that is described and depicted in Exhibit A and
Exhibit B then, and in that event, the Easement Property defined herein shall be revised to include that
strip of land that is centered on the line or equipment as installed, and in such an event, Grantor and
Grantee, shall join in the execution and acceptance of an appropriate substitute easement instrument if
either Grantor or Grantee shall deliver to the other a written request for such a substitute easement
1646963_4. 1
instrument. Grantee shall also have the right of ingress and egress over, under, upon and across the
Grantor's Property for purposes of access to the Easement Property. The easement also includes the rights
and privileges to temporarily use, from time to time, additional space on the Grantor's Property, where
available and necessary, for equipment and materials necessary for the installation, repair and maintenance
of the Improvements located in, under, upon, over, and/or across the Easement Property, to do all acts and
things requisite and necessary for the .full enjoyment of the easement hereby granted, and for nearby
property owners, their grantees, successors, agents, or employees, to connect the premises of such nearby
property owners by service pipes to the Improvements installed by Grantee within the Easement Property,
provided such nearby property owners, their grantees, successors, agents, or employees restore the portion
of the Grantor's Property disturbed by their work to a condition that is as near the condition that existed
just prior to the time the portion was distrubed by them as is practicable.
2. Obligations of Grantee. To the extent practical and within acceptable construction
practices, Grantee shall utilize directional boring for the initial installation of the water utility lines that
are a part of the Improvements. Open cutting or ditches shall be utilized to install service lines, taps,
hydrants, valves or similar items; as needed as part of the directional boring process; where two water
lines intersect or connect; or if problems arise with the directional boring process. Grantee shall not be
required to use directional boring for any future repair, maintencnace, replacement, reconstruction,
relocation of the Improvements. Grantee shall maintain, repair, replace and service the Improvments.
Notwithstanding anything in this Agreement to the contrary, Grantee shall restore the Easement Property
and Grantor's Property, to the extent practicable, to the condition as existed prior to the commencement of
the Project, including driveways thereon. This obligation to restore the driveways shall apply to all future
work, including repair, replacement or relocation of the Improvements.
3. Rights Retained by Grantor. Grantor shall retain unto itself the right to use the Easement
Property for any and all purposes and uses not inconsistent with the foregoing easement. Subject to
Grantee's_rights and obligations in Sections 1 and 2 with respect to the Easement Property, Grantor shall
be entitled to maintain all improvements on tree Grantor's Property in existence as of the date of this
Agreement. With the exception of those Improvements in existence on the date of this Agreement,
Grantor shall not erect or maintain any permanent structures, obstructions, or other improvements under
and/or upon the surface of or over the Easement Property. Grantor shall not perform any act which would
impair or interfere with Grantee's use and enjoyment of the Easement Property or the easement herein
granted. The immediately preceding sentence prohibits (among the other prohibitions effected by it) the
erecting or maintaining in the Easement Property of any earthen mound or series or system of earthen
mounds.
4. Obligations of Grantor. Grantor shall keep the Easement Property free of any fence,
structure, asphalt, gravel, plants, concrete or other improvements (other than those installed by Grantee).
Grantor shall mow and care for the grass located within the Easement Property and shall maintain all other
parts of the Easement Property in good condition. Grantor shall not block, impede or interfere with the
Improvements or Grantee's access to or use of the Easement Property.
5. Easement and Covenants Appurtenant. The easement granted, created and made herein,
together with the benefits thereof, shall run with the Grantor's Property and the Easement Property, inure
to the benefit of Grantee and its grantees, successors and assigns and shall bind Grantor and its grantees,
successors and assigns. All covenants and agreements hereunder may be enforced by an action for
1646963_4. 2
specific performance, and in the event that a party breaches any such covenant or agreement, the other
party may exercise any remedy available hereunder, at law or in equity, and recover from the breaching
party all amounts expended in connection with exercising any such remedy (including without limitation,
court costs and attorneys' fees).
6. Environmental Matters. Grantor covenants and represents that to the best of its knowledge,
neither the Grantor's Property nor the Easement Property is not presently the subject of, nor is there the
threat of any federal, state or states, or local environmentally related lien, proceeding, claim, liability or
action. Grantor agrees that between Grantor and Grantee, the acceptance of this Agreement by Grantee
shall not increase the liability of Grantee for environmentally related claims arising from or related to (i)
conditions on the Grantor's Property or the Easement Property prior to the acceptance of this
Agreement; (ii) acts of Grantor or any other third party; or (iii) conditions on the Grantor's Property or the
Easement Property not created by Grantee.
7. Jurisdiction. Grantor and Grantee agree that any litigation associated with or arising from
this indenture shall be filed with a court of competent jurisdiction within the State of Indiana.
8. Other Obligations. Grantor agrees that this Agreement shall not transfer to Grantee any
past, present, or future obligation(s) of Grantor to be responsible for, or to pay, any tax, assessment, or fee
associated with or related to the Grantor's Property or Easement Property.
9. Waiver. Waiver by either party of any one default hereunder will not be deemed to be a
waiver of any other default under this Agreement. Any remedy or election under this Agreement will not
be deemed exclusive, but instead, whenever legally permissible, will be cumulative with all other
remedies at law or in equity.
10. Amendment. Grantor and Grantee agree that this Agreement shall only be modified or
released by the express, written consent of both Grantor and Grantee. Said consent, when duly recorded,
shall run with the Grantor's Property and the Easement Property.
11. Entire Agreement. This Agreement contains the entire agreement of the parties with respect
to the subject matter hereof, and all prior agreements, communications and negotiations between the parties,
either verbal or written, are hereby merged into this Agreement. This Agreement may be terminated,
modified, or amended only by a writing signed by the parties, and no agreement or consent of any other
persons shall be necessary for such termination,modification, or amendment.
12. Governing Law. This Agreement will be governed by and construed in accordance with the
laws of the State of Indiana.
13. Notice. Any and all notices, demands, requests, submissions, approvals, consents, or other
communications or documents required to be given, delivered or served or which may be given, delivered
or served under or by the terms and provisons of this Agreement or pursuant to law or otherwise, shall be
in writing. All notices shall be either (a) sent by overnight delivery using a nationally recognized
overnight courier, in which case notice shall be deemed delivered one business day after deposit with such
courier, (b) sent by certified or regular U.S. mail, postage prepaid, in which case notice shall be deemed
delivered two business days after deposit in such mails, or (c) sent by personal delivery, in which case
1646963_4. 3
notice shall be deemed delivered upon receipt or refusal of delivery. All notices shall be addressed to the
respective parties as follows:
If to Grantee: City of Carmel
One Civic Square
Carmel, Indiana 46032
Attn: Cannel City Attorney
With a Copy to: City of Carmel
One Civic Square
Carmel, Indiana 46032
Attn: Director of Utilities
If to Grantor:
Any such notice will be effective three days after the notice has been deposited in the United States mail, as
provided above, or if earlier upon receipt.
14. Severability. If any term, covenant, condition or provision of this Agreement or the
application thereof to any person or circumstance, shall at any time or to any extent be held invalid or
unenforceable, the remainder of this Agreement, or the application of such term or provision to persons or
circumstances other than those as to which it is held invalid or unenforceable, shall not be affected
thereby, and each such term, covenant, condition and provision of this Agreement shall continue to be
valid, binding and enforceable to the fullest extent permitted by law.
15. Authori . The person executing this instrument on behalf of Grantor hereby represents that
he/she has the authority to bind Grantor to the terms and conditions set forth herein and that all necessary
action therefore has been taken. Grantor further represents and warrants to Grantee that Grantor is the fee
simple owner of the Easement Property; that Grantor has the right to grant this easement; that Grantor
guarantees the quiet possession of the Easement Property to the Grantee; that the Easement Property is
free of any liens or encumbrances, except the lien of current taxes and any other lien or encumbrance that,
as of the date of execution hereof, appears of public record; and that, subject to the foregoing, Grantor will
warrant and defend Grantee's title to the easement granted hereby against all claims thereon.
16. Attorneys' Fees. In the event of any action or proceeding brought by either party against
the other under this Agreement, the prevailing parry shall be entitled to recover all costs and expenses,
including reasonable attorneys' fees.
IN WITNESS WHEREOF, the parties hereto have executed this Water Line Easement Agreement
as of the day and year first above written.
1646963_4. 4
0
GRANTOR: _____..
BY:
i ature
Printed
v '
Title
1646963_4. 5
GRANTEE:
THE CITY OF CARMEL
By and through its Board of Public Works and Safety
By:
James BrainarX, Presiding Officer
Date:
By'
M Ann Burke 'Member
Date:
By:
Lori,. atson, Member
Date: Z(
ATTEST'
Dian L. Cordray, I'' C, Clerk-Treasurer
Date:—
sanllla M.J �s n,
'DevutY
1646963_4. 6
STATE OF INDIANA )
SS:
COUNTY OF HAMILTON )
Personally appeared before me this day James Brainard, Mary Ann Burke, and Lori Watson, who having
been duly sworn/affirmed, state(s) that they are members of the City of Carmel's Board of Public Works
and Safety and have executed the foregoing Water Line Easement Agreement on behalf of such entity.
WITNESS my hand and notarial seal, this ` ' day of � , 2012
My Commission Expires: ✓� Signed Name: C/ _
Lj
My County of Residence: Printed Name: �&Qlltm (1'1 \��b I-) n&1
1646963_4. 7
STATE OF
SS:
COUNTY OF QU-t
Bef re me, a Not a Public in and for the Staj�e of L t i:�,^U q1 personally appeared
€ by me known to be the °> ' of G� tor, who acknowledged
the ex c tion of the foregoing Water Line Easement Agreement for and on behalf of said Grantor.
T
Witness my hand and Notarial seal this day of Ak"-e— , 2012.
0 tk�Lq__)
My Commission Expires:
t Gt Z�i lic
My Co. my of Resi ence:
9i S;.tiNi
&Iy" - [Printed] NOTARY PUBLIC,STATE OF Oil
COUNTY OF OAXLAND
AAY COIv'NISSION EXPIRES May 2,2013
ACTING IN COUNTY OF O"_-CvA
This instrument was prepared by and after recording return to: Douglas C. Haney, City of Carmel, One
Civic Square, Carmel, IN 46032.
I affirm, under the penalties for perjury, that I have taken reasonable care to redact each Social Security
number in this document, unless required by law. Douglas C. Haney
1646963_4. 8
EXHIBIT 1
Grantor's Property
A part of Block D of WestCarmel Center as per plat thereof recorded as intnumenl
9 DOMD 7496 In Plat Cabinet 2,sllde 515 in the records of Hsmilton County,lndlaha
and being lowed in%t Northwest Quutir of Sxtlon 7,Tov=Wp 17 Noah,Renbc 3
East in Cley Township,Hamilton County,Indlam belts bour,6d as follows:
Commencing et the Southeut Coteau of tht Noilawest Qpmrier of SscUorr 7,Towmbip
17 North,P•a]ge 3 East;chance North 00 ftrees 25 mlauts 52 stands West(ta wr!ad
bearing)691.99 foci along tha Ent Line of said Northwest Quarter to the owthaetL^rn
right-of arty deer of Metal parkwq(me-5ce the.pl4:for Btxk D of Meat Carmel Cents
recorded as ktnmw 6200M374%in Plat Cabluct 2,aUde 515 In the records of
Hamilton County,b4ieaa);thcax South 59 de;=53 niinutcs 19 seconds Wcst 298.61
fxt al=aLtbe northwestotn rlslu•Q-°way line of RstsU Parkway to the PD1KT 09
BXGEOT NG of this dracriptloa;thmrx North 35 degzccs 06 minutm 42 seconds West
208.66 fact;t mna South 53 degrees 53 itiinut:s 19"seconds West 217.91 feet to-die
eastem tight-orway line of US 421(Ktdi4pA Raid)as per said`p1a4 aid point being on
_n^a-tatsent cum concave to tke est and bang South 68 drgnxs 5£xn6jim 12
seconds West 229,1 18.12 feet from the radius paint of said curve;tbcnce southerly
I 13.t5 tees irons tae easretn right-ot-wap line 6i-a 4727C Rc j area along
said turn to northwest=right-of-way lint of R_-tall Parkfty.said point beias South 69
degrees 56 rnlat;6 30 strands West 229,1 I8.12 Fxr from tl*radiui point of said curve,
-thc fonowing six(6)co=;cs are along the nortbwesiarri right•o E way line of RKaii
Parkway;1)thence South 64 deQtees 59 trt u.r.e 41 seconds East 39.57 f:~t;2)thence
North 67 degrees 59 rnlnutes 34 seconds East 45.41 feet to the point of curvature of s
curve to the right,mid point being North 22 degrees 00 minutes 26 seconds West 44.5D
feet from the atdfus point of said curve;3)thence easterly 17.0 fr_t along said curve to
its point of tangency',said poinfof teagcr y btlq North 00 d*rez 00 rdinutes 00
seconds 44.S0 feet from the radius point of said curve;4)thence=North 90 degrees 00
minutes 00_seconds East 44.50 feet to a point on anon-tangent curve concave to the
riaith,Wd point befog South 60 degree 20 niinures 23 seconds East 103_128 feet'hoin the
radius print of said r=ZVc;5)thtnee caste;ly au3:,5:ibees crly 63.07 feet along said-urve,
to a point baing South 35 degrees 07 minutes 32 seconds Gast 103.88 feet from the radius
point of sold curve,6)thence North 53 dWrrs 53 minutes 18 s:onds Fast 74.08 feer to
the POINT OF BEGINNING containing 1.000 nor%morn or less
CArmel Michi;an Road Water main Porter Shank 119 EA.doc
EXHIBIT "An
EASEMENT
A PART OF LOT 2 IN WEST CARMEL CENTER AMENDED SECONDARY PLAT BLOCK D,RECORDED AS INSTRUMENT
NUMBER 200200089230 IN PLAT CABINET 3,SLIDE 98 IN THE OFFICE OF THE RECORDER OF HAMILTON COUNTY,
INDIANA,MORE PARTICULARLY DESCRIBED AS FOLLOWS:
BEGINNING at the Northwest corner of said Lot 2; thence North 53 degrees 53 minutes 18 seconds East,
along the North line of said Lot 2, a distance of 15.54 feet; thence 133.45 feet along an arc to the left
having a radius of 229,088.12 feet and subtended by a long chord with a bearing of South 21 degrees 02
minutes 41 seconds East and a length of 133.45 feet; thence North 64 degrees 59 minutes 41 seconds
West, a distance of 21.62 feet; thence 113.85 feet along an arc to the right having a radius of 229,118.12
feet and subtended by a long chord with a bearing of North 21 degrees 02 minutes 39 seconds West and
a length of 113.85 feet to the PLACE OF BEGINNING; CONTAINING 0.0426 ACRES(1854 SQ.FT.)MORE OR
LESS.
I, Trent E. Newport, a Registered Land Surveyor in the State of Indiana, do hereby certify that this
description was prepared from information obtained from Instrument Number 200200089230, as recorded in
the Hamilton County Recorder's Office. No fieldwork was performed and therefore, this description is
subject to any overlaps, gaps or inconsistencies that a field survey might reveal.
OESTER�p0��
2-10-12
No. 29600021 Trent E. Newport Date
Reg. Land Surveyor No. 29600021
STATE OF State of Indiana
AND 10 p�
qN� SURNO
PREPARED BY:
iall
-312531 -
Transportation&
Development Consultants
3417 scavr m eaw waf x cio�UD Leo-isss
ROAD: MICHIGAN ROAD `��� I� 77 fl DRAWN BY : CJL 12-13-11
PROJECT: MICHIGAN ROAD FDR MAIN ,X\ REVISED BY : CAW 02-10-12
96th ST. 106th ST. CHECKED BY : TEN
COUNTY: HAMILTON EASEMENT EXHIBIT SCALE : 1" = 60'
SECTION: 7
TOWNSHIP: 17 NORTH OWNER: FIFTH THIRD BANK, INDIANA (CENTRAL)
RANGE: 3 EAST RECORD DOCUMENTS: WARRANTY DEED, INST.#200200022424
10 1 30' f o'
® HATCHED AREA IS THE
SCAM't - APPROXIMATE EASEMENT
NORTH
\�y �U,
PLACE OF BEGINNING S`�� FIFTH THIRD BANK. INDIANA \90 �'•
N53'53'18"E 15.5 \\ INST.#200200022424 o,6,
W 6 PE G
65 R HALF / / \
PER PLAT \ 9031 \5, VZ
S• \
WEST CA M L CENTER A—MEN'DEU
\ SECONDARY PLAT
d \ BLOCK "D"
ESF4 �\ LOT 2
Z
\0 10p30006 \ S90 oobo"w
44.50'
9ti6 ARC=17.09'
SFR \
Z��Sj#9001 N64'59'41"W N67'59'34"E 45.41'
21.62'
C1 C2
ARC LENGTH=133.45' ARC LENGTH=113.85' LEGEND
R=229,088.12' R=229,118.12' D.&U.E. — DRAINAGE & UTILITY EASEMENT
CHORD BEARING=S21'02'41"E CHORD BEARING=N21'02'39"W B.S.L. — BUILDING SETBACK LINE
CHORD=133.45' CHORD=113.85'
PREPARED BY:
01STEq F0 No fieldwork was performed and therefore, this description is subject to
Fo any overlaps, gaps or inconsistencies that a field survey might reveal.
This plot was prepared from information obtained from Instrument Number
No. 29600021 200200089230, as recorded in the Hamilton County Recorder's Office.
STATE OF �`- f
l4 S U R�EyO Trent E. Newport Date Transportation&
Reg. Land Surveyor No. 29600021 p
State of Indiana Development Consultants
7117 9UR IX M WF W 46107 01n 19£15%
VOUCHER # 122392 WARRANT # ALLOWED
T1659 IN SUM OF $
FIFTH THIRD BANK
38 Fountain Square Plaza
Cincinnati, OH 45202
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
100812 06-1052-06 $31,800.00
Availability
0
1.
Voucher Total $31,800.00
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
T1659
FIFTH THIRD BANK Purchase Order No.
38 Fountain Square Plaza Terms
Cincinnati, OH 45202 Due Date 10/8/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/8/2012 100812 $31,800.00
I 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
Date O i r