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218435 03/25/2013 CITY OF CARMEL, INDIANA VENDOR: 00350320 Page 1 of 1 ONE CIVIC SQUARE E&B PAVING,INC CARMEL, INDIANA 46032 17042 MIDDLETOWN AVE CHECK AMOUNT: $31,320.23 NOBLESVILLE IN 46060 CHECK NUMBER: 218435 CHECK DATE: 3/25/2013 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 202 R4350900 7 31, 320 . 23 OTHER CONTRACTED SERV CITY OF CARMEL PROJECT NO. 11 -09 Illinois Street Extension Progress Estimate Summary Sheet Et Signature Page Progress Estimate No 7 Partial x Final Earned to date $ 2,564,886.40 Previous payments $ 2,533,566.17 Earnings this estimate $ 31,320.23 Retainage $ - Amount due Contractor $ 31,320.23 CONTRACTOR: DATE: 3-12-13 Et B Paving Co., Inc. Phone: (317) 773-4132 17042 Middletown Avenue Fax: (317) 773-4137 Noblesville, IN 46060 CONSULTANT: ,I DATE: 3112-1 13 AMERICAN STRLICTLIREPOINT, INC. Phone: (317) 547-5580 7260 Shadeland Station Fax: (317) 543-0270 Indianapolis, Indiana 46256-3957 APPROVED BY: DATE: CITY OF CARMEL Construction Pay Estimate Report 3/12/2013 1:46 PM City of Carmel FieldManager 4.5a Contract: _Carmel 11-09, Illinois Street Extension Estimate Estimate Entered Estimate Managing No. Date By Type Office 7 3/12/2013 David Machala MONTHLY American Structurepoint, Inc. All Contract Construction Prime Contractor Work Completed Started Date E&B Paving 17042 Middletown Avenue Noblesville IN 46060 Comments Item Usage Summary Project: 11-09,Illinois Street Extension Category: 1, Base Bid Prop. Project Item Mod. Item Description Unit Item Code Ln. Line No. Type No. Quantity Item Price Dollar Amount Additional Clearing-Ash Trees LS _0417 1021 0646 CO 001 1.000 7,547.22 $7,547.22 Field Office,C MOS _0346 0051 0255 00 000 4.000 2,117.19 $8,468.76 Pipe,Reinforced Concrete, 12 in. LFT _0350 0056 0280 00 000 -57.750 32.00 $-1,848.00 Pipe,Reinforced Concrete, 15 in. LFT _0351 0057 0285 00 000 57.750 36.00 $2,079.00 Video Inspection for Pipe LFT _0349 0055 0275 00 000 4,587.750 1.00 $4,587.75 Video Inspection for Underdrains LFT _0174 0062 0310 00 000 7,235.500 1.00 $7,235.50 Subtotal for Category 1: $28,070.23 Category: 2,Alternate Bid#1 Prop. Project Item Mod. Item Description Unit Item Code Ln. Line No. Type No. Quantity Item Price Dollar Amount 12"x 12"x 6"Water Main Tee EACH _0397 1010 0605 00 000 1.000 950.00 $950.00 Gate Valve, 12" EACH _0398 1011 0610 00 000 1.000 2,300.00 $2,300.00 Subtotal for Category 2: $3,250.00 Subtotal for Project 11-09: $31,320.23 Total Estimated Item Payment: $31,320.23 Time Charges Site Site Description Site Method Days Charged Liq. Damages 00 Overall Contract Site Completion Date $0 Total Liquidated Damages: $0 Contract ID: _Carmel 11-09 Estimate:7 Page 1 of 2 Construction Pay Estimate Report 3/12/2013 1:46 PM City of Carmel FieldManager 4.5a Pre-Voucher Summary Stockpile Project Voucher No. Item Payment Adjustment Dollar Amount 11-09, Illinois Street Extension 0007 $31,320.23 $0.00 $31,320.23 Voucher Total: $31,320.23 Summary Current Voucher Total: $31,320.23 Earnings to date: $2,564,886.38 -Current Retainage: $0.00 Retainage to date: $192,330.10 -Current Liquidated Damages: $0.00 Liquidated Damages to date: $0.00 -Current Adjustments: $0.00 -Adjustments to date: $0.00 Total Estimated Payment: $31,320.23 Net Earnings to date: $2,372,556.28 -Payments to date: $2,341,236.05 Net Earnings this period: $31,320.23 Estim7 2-119 Certif' tion 3 PR-American Structurepoint, Inc. (Date) 3-1'Z- 13 E& B Paving Co., Inc. (Date) City of Carmel (Date) Contract ID: _Carmel 11-09 Estimate:7 Page 2 of 2 Construction Pay Estimate Amount Balance Report Estimate: 7 3/12/2013 1:46 PM City of Carmel FieldManager 4.5a Contract: _Carmel 11-09,Illinois street Extension Project: 11-09,Illinois Street Extension Category: 1,Base Bid Prop. Item Authorized Quantity This Qty.Paid Total Qty. Dollar Amt. Line Item Description Code Qty. Unit Estimate To Date Placed %Cpt Unit Price Paid To Date 0001 Construction Engineering _0273 1.000 LS 0.700 0.700 70% 28,500.00000 $19,950.00 0002 Mobilization And Demobilization _0151 1.000 LS 1.000 1.000 100% 173,207.10000 $173,207.10 0003 Clearing Of Right-Of-Way _0210 1.000 LS 0.800 0.800 80% 40,000.00000 $32,000.00 0004 Houses and buildings,Remove,Parcel 0313 1.000 LS 1.000 1.000 100% 15,000.00000 $15,000.00 No 4 - 0005 Excavation,Common _3081 18,009.000 CYD 12,891.000 12,891.000 72% 12.00000 $154,692.00 0006 Borrow _0314 11,262.000 CYD 8,262.000 8,262.000 73% 0.50000 $4,131.00 0007 Temporary Erosion and Sediment _0315 2.000 EACH 0.000 85.00000 Control,Culvert Pipe Protection 0008 Temporary Erosion and Sediment _0316 70.000 EACH 0.000 65.00000 Control,Curb Inlet Protection 0009 Temporary Check Dam,Revetment _0119 144.000 TON 19.890 19.890 14% 30.00000 $596.70 Riprap 0010 Temporary Ditch Inlet Protection _0121 2.000 EACH 0.000 85.00000 0011 Temporary Mulching _0115 12.000 TON 0.000 450.00000 0012 Temporary Silt Fence _0123 6,163.000 LFT 6,756.000 6,756.000 110% 1.15000 $7,769.40 0013 No.2 Stone _0147 200.000 TON 0.000 20.00000 0014 Subgrade Treatment,Type IIIA _0317 1,329.000 SYD 763.600 763.600 57% 6.50000 $4,963.40 0015 Subgrade Treatment,Type IC _0318 11,307.000 SYD 254.300 254.300 2% 11.15000 $2,835.45 0016 Structural Backfill _0319 4,184.000 CYD 3,372.800 3,372.800 81% 20.25000 $68,299.20 0017 Chemical Modification,Soils _0320 30,582.000 SYD 31,728.200 31,728.200 104% 5.25000 $166,573.05 0018 Compacted Aggregate,No.53 Base _3010 861.000 TON 232.360 232.360 27% 30.00000 $6,970.80 0019 Coarse Aggregate,8 _0321 12.000 TON 0.000 30.00000 0020 Compacted Aggregate,No.53 _0322 244.000 TON 19.640 19.640 8% 20.00000 $392.80 0021 Milling,Asphalt,1 1/2 in _0323 3,034.000 SYD 0.000 2.76000 0022 HMA Surface,Type A _0324 104.000 TON 0.000 100.00000 0023 HMA Surface,Type C _0185 2,937.000 TON 0.000 65.00000 0024 HMA Intermediate,Type A _0325 311.000 TON 0.000 85.00000 0025 HMA Intermediate,Type C _0326 4,508.000 TON 3,295.980 3,295.980 73% 48.00000 $158,207.04 0026 HMA Base,Type C _0327 13,227.000 TON 8,603.100 8,603.100 65% 46.00000 $395,742.60 Contract: _Carmel 11-09 Estimate:7 Page 1 of 6 Construction Pay Estimate Amount Balance Report Estimate: 7 3/12/2013 1:46 PM City of Carmel FieldManager 4.5a Project: 11-09,Illinois Street Extension Category: 1,Base Bid Prop. Item Authorized Quantity This Qty.Paid Total Qty. Dollar Amt. Line Item Description Code Qty. Unit Estimate To Date Placed %Cpt Unit Price Paid To Date 0027 HMA,Type C,Intermediate,OG 19.Omm _0328 4,116.000 TON 3,397.340 3,397.340 83% 50.00000 $169,867.00 0028 Asphalt for Tack Coat _0184 28.000 TON 17.210 17.210 61% 525.00000 $9,035.25 0029 Decorative Concrete Pavement,Truck 0329 260.000 SYD 121.400 121.400 47% 105.00000 $12,747.00 Apron - 0030 Decorative Concrete.4 in. _0330 92.000 SYD 69.840 69.840 76% 75.00000 $5,238.00 0031 Curb Ramp,Concrete,C _0331 111.000 SYD 53.350 53.350 48% 175.00000 $9,336.25 0032 Curb Ramp,Concrete,G _0168 29.000 SYD 0.000 105.00000 0033 Curb Ramp,Concrete,L _0332 125.000 SYD 51.380 51.380 41% 135.00000 $6,936.30 0034 Curb,Modified,Roll _0333 635.000 LFT 267.250 267.250 42% 13.00000 $3,474.25 0035 Curb,Concrete,Straight _0334 560.000 LFT 231.000 231.000 41% 13.00000 $3,003.00 0036 Curb and Gutter,Type II _0335 10,583.000 LFT 7,969.000 7,969.000 75% 11.50000 $91,643.50 0037 Curb and Gutter,Type III _0336 9,453.000 LFT 7,541.750 7,541.750 80% 11.50000 $86,730.13 0038 Curb and Gutter Turnout Concrete _0337 14.000 LFT 0.000 95.00000 0039 HMA for Approaches,Type B _0338 264.000 TON 0.000 85.00000 0040 Mailbox Assembly,Single _0149 2.000 EACH 0.000 250.00000 0041 Geotextiles _3085 226.000 SYD 0.000 2.00000 0042 Riprap,Revetment _0339 86.000 TON 57.300 57.300 67% 35.00000 $2,005.50 0043 Mobilization and Demobilization for _0114 4.000 EACH 1.000 1.000 25% 300.00000 $300.00 Seeding 0044 Fertilizer _0340 2.000 TON 0.000 1,050.00000 0045 Seed Mixture,U _0341 849.000 LBS 0.000 5.50000 0046 Seed Mixture,T _0342 673.000 LBS 8.000 8.000 1% 3.05000 $24.40 0047 Mulching Material _0343 10.000 TON 0.000 370.00000 0048 Water _0344 28.000 MG 0.000 0049 Topsoil 0345 1.00000 _ 2,222.000 CYD 0.000 8.00000 0050 Sodding,Nursery _0117 7,570.000 SYD 0.000 3.08000 0051 Field Office,C _0346 18.000 MOS 4.000 9.500 9.500 53% 2,117.19000 $20,113.31 0052 Pipe End Section,Precast Concrete,12 _0347 17.000 EACH 11.000 11.000 65% 525.00000 $5,775.00 in Contract: _Carmel 11-09 Estimate:7 Page 2 of 6 Construction Pay Estimate Amount Balance Report Estimate:7 3/12/2013 1:46 PM City of Carmel FieldManager 4.5a Project: 11-09,Illinois Street Extension Category: 1,Base Bid Prop. Item Authorized Quantity This Qty.Paid Total Qty. Dollar Amt. Line Item Description Code Qty. Unit Estimate To Date Placed % Cpt Unit Price Paid To Date 0053 Pipe End section,Precast Concrete,36 _0348 2.000 EACH 2.000 2.000 100% 1,300.00000 $2,600.00 in. 0054 Pipe,Type 4,Circular,6 In _0173 8,918.000 LFT 7,514.500 7,514.500 84% 4.30000 $32,312.35 0055 Video Inspection for Pipe _0349 5,851.000 LFT 4,587.750 4,587.750 4,587.750 78% 1.00000 $4,587.75 0056 Pipe,Reinforced Concrete,12 in. _0350 3,157.000 LFT -57.750 2,154.250 2,154.250 68% 32.00000 $68,936.00 0057 Pipe,Reinforced Concrete,15 in. _0351 371.000 LFT 57.750 171.750 171.750 46% 36.00000 $6,183.00 0058 Pipe,Reinforced Concrete,18 in. _0352 113.000 LFT 121.000 121.000 107% 38.00000 $4,598.00 0059 Pipe,Reinforced Concrete,24 in. _0353 423.000 LFT 423.000 423.000 100% 50.00000 $21,150.00 0060 Pipe,Reinforced Concrete,30 in. _0354 668.000 LFT 668.000 668.000 100% 71.00000 $47,428.00 0061 Pipe,Reinforced Concrete,36 in. _0355 1,119.000 LFT 1,085.000 1,085.000 97% 83.00000 $90,055.00 0062 Video Inspection for Underdrains _0174 3,000.000 LFT 7,235.500 7,235.500 7,235.500 241% 1.00000 $7.235.50 0063 Aggregate For Underdrains _0171 833.000 CYD 734.510 734.510 88% 33.00000 $24,238.83 0064 Geotextiles For Underdrain _0172 9,690.000 SYD 7,674.610 7,674.610 79% 1.00000 $7,674.61 0065 Manhole,J10 0356 1.000 EACH 1.000 1.000 100% - 3,600.00000 $3,600.00 0066 Casting Adjust to Grade _0357 4.000 EACH 0.000 700.00000 0067 Inlet,F7 0358 1.000 EACH 0.000 - 1,500.00000 0068 Inlet,J10 _0359 26.000 EACH 25.000 25.000 96% 1,800.00000 $45,000.00 0069 Inlet,M10 0360 8.000 EACH 3.000 3.000 38% - 2,000.00000 $6,000.00 0070 Catch Basin,K10 0361 35.000 EACH 30.000 30.000 86% - 2,200.00000 $66,000.00 0071 Manhole,C4 _0405 10.000 EACH 9.000 9.000 90% 1,850.00000 $16,650.00 0072 Manhole,C2 _0362 1.000 EACH 0.000 2,100.00000 0073 Manhole,J4 _0363 13.000 EACH 13.000 13.000 100% 3,400.00000 $44,200.00 0074 Construction Sign,C _0364 10.000 EACH 2.000 2.000 20% 238.00000 $476.00 0075 Road Closure Sign Assembly _0365 13.000 EACH 5.000 5.000 38% 141.00000 $705.00 0076 Detour Route Marker Assembly _0366 46.000 EACH 0.000 81.00000 0077 Construction Slgn,A 0367 20.000 EACH 7.000 7.000 35 - 164.00000 $1,146.00 0078 Maintaining Traffic _0086 1.000 LS 0.500 0.500 50% 35,188.64000 $17,594.32 0079 Barricade,III-A 0368 204.000 LFT 132.000 132.000 65 - 13.00000 $1,716.00 Contract: _Carmel 11-09 Estimate:7 Page 3 of 6 Construction Pay Estimate Amount Balance Report Estimate: 7 3/12/2013 1:46 PM City of Carmel FieldManager 4.5a Project: 11-09,Illinois Street Extension Category: 1,Base Bid Prop. Item Authorized Quantity This Qty.Paid Total Qty. Dollar Amt. Line Item Description Code Qty. Unit Estimate To Date Placed %Cpt Unit Price Paid To Date 0080 Barricade,111-8 0369 144.000 LFT 24.000 24.000 17% 15.00000 $360.00 0081 Sign Post,Square,1,Reinforced Anchor _0088 681.000 LFT 85.000 85.000 12% 13.50000 $1,147.50 Base 0082 Sign,Sheet,Relocate _0370 23.000 EACH 0.000 20.00000 0083 Sign,Sheet,with Legend,0.080 In. _0093 196.000 SFT 22.000 22.000 11% 15.00000 $330.00 0084 Sign,Sheet,with Legend,0.100 In. _0094 96.000 SFT 23.680 23.680 25% 16.00000 $378.88 0085 Irrigation Conduit,PVC,4 in. _0371 500.000 LFT 292.000 292.000 58% 9.00000 $2,628.00 0086 Decorative Street Lighting,Wiring and 0372 8.000 EACH 3.500 3.500 44% 9,500.00000 $33,250.00 Installation 0087 Lighting Power Distribution Panel _0373 2.000 EACH 1.000 1.000 50% 6,000.00000 $6,000.00 0088 Handhole 0374 16.000 EACH 8.000 8.000 50% - 875.00000 $7,000.00 0089 Decorative Street Sign Assembly _0375 8.000 EACH 0.000 1,650.00000 0090 Cable Interduct 0376 6,031.000 LFT 3,642.500 3,642.500 60 - 11.00000 $40,067.50 0091 Handhole,Lighting 0083 8.000 EACH 5.000 5.000 63 - 600.00000 $3.000.00 0092 Conduit,Steel,Galvanized,2 in.for _0081 508.000 LFT 180.000 180.000 35% 12.00000 $2,160.00 Lighting 0093 Wire,#4 Copper In Plastic Duct,In _0406 1,415.000 LFT 703.000 703.000 50% 10.00000 $7,030.00 Trench,4,1/C 0094 Transverse Marking Thermoplastic _0377 720.000 LFT 0.000 4.05000 Crosswalk,White 24" 0095 Line,Thermoplastic,Broken,White,4 in. _0062 1,820.000 LFT 0.000 0.50000 0096 Line,Thermoplastic,Solid,White,4 in. _0061 4,178.000 LFT 0.000 0.45000 0097 Line Thermoplastic,Solid,White,6 in _0378 606.000 LFT 0.000 1.25000 0098 Line,Thermoplastic,Solid,Yellow,4 in. _0064 11,380.000 LFT 0.000 0.45000 0099 Transverse Marking,Thermoplastic, _0379 633.000 LFT 0.000 1.95000 Solid,Yellow,Crosshatch Line,12" 0100 Transverse Markings,Thermoplastic, _0063 426.000 LFT 0.000 1.25000 Crosswalk Line,6 in. 0101 Pavement Message Marking, _0380 11.000 EACH 0.000 80.00000 Thermoplastic,Lane Indication Arrow 0102 Snowplowable Raised Pavement Marker _0381 18.000 EACH 0.000 46.10000 Contract: _Carmel 11-09 Estimate:7 Page 4 of 6 Construction Pay Estimate Amount Balance Report Estimate: 7 3/12/2013 1:46 PM City of Carmel FieldManager 4.5a Project: 11-09,Illinois Street Extension Category: 1,Base Bid Prop. Item Authorized Quantity This Qty.Paid Total Qty. Dollar Amt. Line Item Description Cade Qty. Unit Estimate To Date Placed %Cpt Unit Price Paid To Date 0103 Pavement Message Marking, _0382 24.000 EACH 0.000 125.00000 Thermoplastic,Fishhook Lane Indication Arrow 0104 Transverse Marking,Thermoplastic, 0383 232.000 LFT 0.000 10.00000 "Sharks Teeth" 0105 Line,Thermoplastic,Broken,White, _0384 517.000 LFT 0.000 3.00000 12in.,3ft Stripe-3ft Gap 0106 Line,Thermoplastic,Broken,White,6in., _0385 311.000 LFT 0.000 1.87000 3ft Stripe-3ft Gap 0107 Erosion Control Blanket _0386 6,835.000 SYD 640.000 640.000 9% 1.08000 $691.20 0108 Pipe,Sanitary Sewer,10" _0387 134.000 LFT 122.250 122.250 91% 52.00000 $6,357.00 0109 Sanitary Manhole _0388 2.000 EACH 2.000 2.000 100% 2,500.00000 $5,000.00 0110 B-Borrow _0201 278.000 CYD 179.200 179.200 64% 23.00000 $4,121.60 0111 Fire Hydrant,Relocate _0389 4.000 EACH 1.000 1.000 25% 6,500.00000 $6,500.00 0112 Valve Box,Adjust to Grade _0390 6.000 EACH 0.000 750.00000 0113 Pipe End Section,Precast Concrete,15 0391 2.000 EACH 0.000 550.00000 in. 1021 Additional Clearing-Ash Trees _0417 1.000 LS 1.000 1.000 1.000 100% 7,547.22000 $7,547.22 1022 Chemical Modifier,Soils,Wet Material _3094 0.000 TON 0.000 128.66000 1023 Additional Earthwork after Chemical _3095 0.000 LS 0.000 6,410.76000 Modification 1024 Remobilization of Chipper for Cox Parcel _3096 0.000 LS 0.000 1,573.71000 1025 Restake Ditch and Outlet Pipes _3097 0.000 LS 0.000 1,166.30000 1026 Installation of Additional Drainage _3098 0.000 LS 0.000 4,558.69000 Structures 1027 Remove/Install Sloped Concrete Island _3099 0.000 LS 0.000 5,665.05000 Noses 1028 Sloped Concrete Island Nose _3100 0.000 SYD 0.000 196.00000 Subtotal for Category 1: $2,291,216.69 Contract: _Carmel 11-09 Estimate:7 Page 5 of 6 Construction Pay Estimate Amount Balance Report Estimate:7 3/12/2013 1:46 PM City of Carmel FieldManager 4.5a Project: 11-09,Illinois Street Extension Category: 2,Alternate Bid#1 Prop. Item Authorized Quantity This Qty.Paid Total Qty. Dollar Amt. Line Item Description Code Qty. Unit Estimate To Date Placed % Cpt Unit Price Paid To Date 1001 Construction Engineering _0273 1.000 LS 1.000 1.000 100% 710.00000 $710.00 1002 Mobilization And Demobilization _0151 1.000 LS 1.000 1.000 100% 21,519.00000 $21,519.00 1003 Water Main,Ductile Iron,12 in. _0392 3,047.000 LFT 2,820.000 2,820.000 93% 44.00000 $124,080.00 1005 Water Main,Ductile Iron,8 in _0393 5.000 LFT 16.000 16.000 320% 127.00000 $2,032.00 1006 Tapping Sleeve With Valve _0394 2.000 EACH 1.000 1.000 50% 6,000.00000 $6,000.00 1007 12"Water Main Tee _0395 3.000 EACH 3.000 3.000 100% 1,200.00000 $3,600.00 1009 12"x 12'x 8"Water Main Tee _0396 1.000 EACH 0.000 1,000.00000 1010 12"x 12"x 6"Water Main Tee _0397 5.000 EACH 1.000 5.000 5.000 100% 950.00000 $4,750.00 1011 Gate Valve,12" _0398 4.000 EACH 1.000 8.000 8.000 200% 2,300.00000 $18,400.00 1012 B Borrow _0399 987.000 CYD 1,244.000 1,244.000 126% 22.00000 $27,368.00 1013 Coarse Aggregate,No 8 _0400 179.000 TON 20.980 20.980 12% 16.00000 $335.68 1014 Fire Hydrant Assembly 3042 7.000 EACH 7.000 7.000 100 - 4,500.00000 $31,500.00 1017 45 degrees Bend,12" _0401 10.000 EACH 2.000 2.000 20% 800.00000 $1,600.00 1018 11.25 degrees Bend,12" _0402 9.000 EACH 1.000 1.000 11% 800.00000 $800.00 1019 Street Cut Repair _0403 8.000 SYD 0.000 305.61000 1020 Asphalt Path Repair _0404 11.000 SYD 0.000 340.76000 Subtotal for Category 2: $242,694.68 Subtotal for Project 11-09: $2,533,911.37 Percentage of Contract Completed(curr): 66% Total Amount Earned This Estimate: $31,320.23 (total earned to date/total of all authorized work) Total Amount Earned To Date: $2,533,911.37 Contract: _Carmel 11-09 Estimate:7 Page 6of6 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee E&B Paving Purchase Order No. 17042 Middletown Ave Terms Noblesville, IN 46060 Date Due Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s) Amount 3/12/2013 7 Illinois Street 106th to 116th $ 31,320.23 Total $ 31,320.23 1 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. ,20 Clerk-Treasurer VOUCHER NC WARRANT NO. E&B Paving ALLOWED 20 17042 Middletown Ave IN SUM OF $ Noblesville, IN 46060 $ 31,320.23 ON ACCOUNT OF APPROPRIATION FOR Board Members Po#or INVOICE NO. ACCT#/TITLE AMOUNT I hereby certify that the attached invoice(s), DEPT# 26536 7 2o2-RSOS $ 31,32023 or bill(s) is (are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except 2Z2&2(3122/2013 Signature City Engineer Title Cost Distribution ledger classification if claim paid motor vehicle highway fund