216901 01/29/2013 \�f CITY OF CARMEL, INDIANA VENDOR: 366611 Page 1 of 1
ONE CIVIC SQUARE TCB FARMS
CARMEL, INDIANA 46032 202 E.COLONIAL ST CHECK AMOUNT: $614.25
PO BOX 28 CHECK NUMBER: 216901
KEMPTON IN 46049
CHECK DATE: 1/29/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 104 614 .25 OTHER EXPENSES
Jan 1013 04:13p Kempton Grain&Supply 765-947-5103
p.2
TGR . R
INVOICE
202 E Colonial St., PO BOX 28
Kempton, IN 46050 765-947-7019
SOLD TO:
Carmel Waste Water Treatment Plant INVOICE NUMBER 104
9609 Hazel Dell Parkway INVOICE DATE January 10,2013
Indianapolis, IN 46280 OUR ORDER NO.
YOUR ORDER NO.
TERMS
SHIPPEDTO: SALES REP
Same SHIPPED VIA
F.O.B.
PREPAID or COLLECT
Sales Tax Rate:
OUANTI Y DESCRIPTIoN UNT PRICE AMOUNT
189 Yards of Carmel Bic-Solids for the month of I of December 2012 3.25 $614.25
$5.00/yard minis($1.75/yard for Spreader Truck Rental=$3.25lyard
SUBTOTAL 614.25
TAX
FREIGHT
$614.25
DIRECT ALL INQUIRIES TO: MAKE ALL CHECKS PAYABLE TO: PAY THIS
Carrie Boyer TCB Farms LLC AMOUNT
765-947-7019
tmbldl(a-)aol.com 202 E Colonial St
Kempton, IN 46049
THANK YOU FOR YOUR BUSIMESSI
VOUCHER # 126552 WARRANT # ALLOWED
366611 IN SUM OF $
TCB FARMS
202 E. COLONIAL ST.
PO BOX 28
KEMPTON, IN 46049
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
104 01-7110-05 $614.25
Voucher Total $614.25
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
366611
TCB FARMS Purchase Order No.
202 E. COLONIAL ST. Terms
PO BOX 28 Due Date 1/24/2013
KEMPTON, IN 46049
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/24/2013 104 $614.25
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