216861 01/29/2013 CITY OF CARMEL, INDIANA VENDOR: 366093 Page 1 of 1
ONE CIVIC SQUARE REPUBLIC WASTE SERVICE-TRASH COMCK AMOUNT: $123,420.20
=4 '� CARMEL, INDIANA 46032 ATTN:NANCY COLLINS
832 LANGSDALE AVE CHECK NUMBER: 216861
INDIANAPOLIS IN 46202-1150
CHECK DATE: 1/29/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1/7-1/26 123 , 420 .20 OTHER EXPENSES
Republic Services
832 Langsdale Ave
Indianapolis, IN 46202-1150
ATTN: Nancy Collins
Account# 3-0761-9761020
$$$$ Collected By Carmel Utilities
Jan 7 to Jan 26 $126,917.70
Cart Deliveries-December $ 100.00
Less Administrative Fee
14390 Payments $ (3,597.50)
Payment to Republic $123,420.20
Prescribed by State Board of Accounts
Form No.301(Rev.1995) ACCOUNTS PAYABAE VOUCHER
TO ` J�LIC- JIt�DDS✓�
ADDRESS
Invoice Date Invoice Number Item Amount
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and that the materials or services
itemized thereon for which charge is made were ordered and :T d exc
ept
C�« a /5
Signature V Title
I hereby certify1hat 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.
19
Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ACCT.
NO.
CARMEL, INDIANA
or Of
(-a.4 U 50A,t /1A ;
Total Amount of Voucher $
Deductions
Amount of Warrant $
�3
Month of )(a,
VOUCHER RECORD Acct.
No.
Source of Supply
Water Treatment
Transmission and Dist.
Customer Accounts
Administrative and General
Operation-Maintenance
Utility Plant in Service
Constr. Work in Progress
Materials and Supplies
Customers Deposits
Total t
Allowed
Board of Control
Filed
Official Title
BOYCE FORMS•SYSTEMS 1-800-382-8702 325
f