216035 01/09/2013 CITY OF CARMEL, INDIANA VENDOR: 00352077 Page 1 of 1
` ONE CIVIC SQUARE FLUID WASTE SERVICES INC
CARMEL, INDIANA 46032 PO BOX 264
CHECK AMOUNT: $1,711.25
NOBLESVILLE IN 46061 CHECK NUMBER: 216035
CHECK DATE: 119/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 W07059 1, 711 . 25 CONT SVS-OTHER
Fluid Waste Services, Inc. Invoice
P. O. Box 264
Noblesville, IN 46061 Date Invoice#
317 773-7996
12/11/2012 WO-7059
Bill To
CITY OF CARMEL WWTP
760 Third Avenue SW
Carmel,IN 46032
US
P.O. No. Terms Project
Net 30
Description Qty Rate Amount
Monday 12-10-12&Tuesday 12-11-12
Contact:Joe Faucett 716-3905
Site:City of Carmel :
1)3 Woodland Drive
2) 1326 Cool Creek Drive
3)221 E.Main Street
4)3715 Chadwick Drive
Crew:LR/AR,EM/EP
Unit: T-21
Televise sanitary sewer for inspection as directed
using lateral launch camera as needed.Monday-
Crew located capped lateral at Woodland Drive.
Tuesday-Crew located blockages in remaining(3)
locations.
TELEVISE AS DIRECTED-HOURLY RATE 9.25 185.00 1,711.25
TERMS NET 30
ADD A LATE FEE AFTER 15 DAYS
Thank You for Your Business.We accept Visa MC&Discover.Please reference Inv.No.On
Remittance Total $1,71).25
Payments/Credits $0.00
Balance Due $1,711.25
VOUCHER # 126411 WARRANT # ALLOWED
352077 IN SUM OF $
FLUID WASTE SERVICES,INC.
PO BOX 264
Noblesville, IN 46061
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
W07059 01-7360-02 $1,711.25
20 I �-
Voucher Total $1,711.25
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
352077
FLUID WASTE SERVICES,INC. Purchase Order No.
PO BOX 264 Terms
Noblesville, IN 46061 Due Date 12/28/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/28/201; W07059 $1,711.25
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
llc/li3
Date Officer