HomeMy WebLinkAboutSMOCK FANSLER CORPORATION- 003246- 10/18/2012 CARMEL REDEVELOPMENT COMMISSION 003246
Srriock Fansler Corporation Check: 3246
2910 W Minnesota Street Date: 10/18/2012
Indianapolis, IN 46241-4541 Vendor: SMOCKFA1
Prior
invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid
726 10,961.00 10,961.00 0.00 0.00 10,961.00
Fountain Eq fencing
10,961.00 10,961.00 0.00 0.00 10,961.00
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_ I EKEYipppocumEmITLSEcURITYMEATAC IYATED2njUMB_PRINTS'ADDITION]ALfSECURR,M,FEATURES INCLUOEDMSEEBACK FORDEDNILS,
4"s56"sic Carmel Redevelopment Commission 003246
• `ti 30 West Main Street A.REGIONS
Suite 220 20-142i/740
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4 srnici Carmel, IN 46032
3246 •
DATE AMOUNT
10/18/2012 10,961.00
I PAT THE SUM OF TEN THOUSAND NINE HUNDRED SIXTY ONE DOLLARS AND NO CENTS ******n****`*
TO THE
ORDER •
OF Smock Fansler Corporation
2910 W Minnesota Street
Indianapolis, IN 46241-4541
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u°00 3 24611° e:0 740 l4 2 l 31: 008790411 lo°
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CARMEL REDEVELOPMENT COMMISSION 003246
Smock Fansler Corporation Check: 3246
2910 W Minnesota Street Date: 10/18/2012
Indianapolis, IN 46241-4541 Vendor: SMOCKFA1
Prior
Invoice P.O. Num. Invoice Amt Balance Retention Discount Amt. Paid
726 10,961.00 10,961.00 0.00 0.00 10,961.00
Fountain Eq fencing
10,961.00 10,961.00 0.00 0.00 10,961.00
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52 COMPNTEREASE FORMS OIMIStON(977)577.5791 T-71771
(CA
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• • Smock Fansler Corporation
2910 W. Minnesota Street INVOICE
Indianapolis IN 46241-
Invoice No:726
(317) 248-8371 Date:7/10/2012
Bill To: Due Date:8/9/2012
CARMEL REDEVELOPMENT COMMISSI
30 W. MAIN ST. Job No:11023
Description: HANOVER SQ FOUNT @ CITY CTR.
CARMEL IN 46032 PO #:
Quantity Description Unit Price Extended Price
FOUNTAIN EQUIPMENT FENCING
1.00 TOTAL AMOUNT DUE 10,961.00 10,961.00
REC'0 .!UL 1 3 2012
Thank You For Your Business! Amount Now Due: 10,961.00
Terms:Net 30 Days
AFFIDAVIT AND WAIVER OF LIEN
[X] Final [ ] Partial [X] Payment to Follow
State of Indiana
County of Marion
William A. Fansler . being duly sworn states that be is the Vice President of SMOCK FANSLER
CORP. having contracted with: Carmel Redevelopment Commission to furnish certain labor,
materials, and/or services as follows: Misc. Construction for a project known as: SFC#11-023
Hanover Sq. Fountain ) Clay Ctr. located at Carmel, IN and does hereby state on behalf of the
a toremen Iioned contractor:
(PARTIAL WAIVER)that there is due from the owner the sum of: (S0.00)
[ ] receipt of which is hereby acknowledged; or
[ ] the payment of which has been promised as the sole consideration of this Affidavit and Partial Waiver of
Lien which is given solely with respect to said amount, and which waiver shall he effective only upon
receipt of payment thereof by the undersigned;
(FINAL WAIVER) that the final balance due from the owner is the sum of($10,961.00)
Ten Thousand Nine Hundred Sixty One Dollars and No/100
[ ] receipt of which is hereby acknowledged;or
[X] the payment of which has been promised as the sole consideration of this Affidavit and Final Waiver of
Lien which shall become effective upon receipt of such payment.
'II IEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all lien or
claim whatsoever on the above-described property and improvements thereon on account of Labor,
Materials, and/or Services; furnished by the undersigned thereto, subject to limitations or conditions
expressed herein, if any; and further certifies that no other party has any claim or right to a lien on
account of any work perforated, materials, or services furnished to the undersigned for said project, and
within the scope of this affidavit and waiver.
SMOCK FANSLER CORP. By \ L4; �l �c.. 4. Title Vice President
William A. Fansler
\\\,hp-VARYp 474.
WITNESS MY HAM) AND NOTARIAL SEAL, this 10'x' day of July , 2012. o etc
•Melissa J. Bisl op Notary 'ublic = SEAL ,*_
/5,•.,
My commission expires November 30, 2016 Residing in Morgan County -- INDIA
rNP����"°��
vrtsonhed by State aoam of Accounts ACCOUNTS PAYABLE VOUCHER City Form No.201(aev.1995)
CITY OF CARMEL
An invoice or bill to be properly itemized muss show: kind of service, where performed, dates service rendered, by
' whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
1:7 "'A" Co✓Derr/,v, Purchase Order No.
2 9/D 66", Aso7v e- Terms
4-/ovs /CJ 9424'/ Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
77/6'/2 726 r„. f�,y keQe..4 r,/ /ix'-;, /U 96/-UG
Total /056/-66'
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accor-
dance with IC 5-11-10-1.6.
)5 I$ 20It`.
-Treasurer