223438 08/27/2013 "*F CITY OF CARMEL, INDIANA VENDOR: 00353052 Page 1 of 1
z„ ONE CIVIC SQUARE CONCRETE SURGEONS INC CHECK AMOUNT: $300.00
s CARMEL, INDIANA 46032 4761 INDUSTRIAL PARKWAY
`o INDIANAPOLIS IN 46226 CHECK NUMBER: 223438
CHECK DATE: 8/2712013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 30821 300 . 00 OTHER EXPENSES
THE CONCRETE SURGEONS, INC. Invoice
hi, 4761 INDUSTRIAL PARKWAY
INDIANAPOLIS, IN 46226
MEM (3 17)897-0600
(800)822-3844 FAX(317)897-0606
SAWING 8 DRILLING SPECIALISTS
8/15/2013 30821
CARMEL UTILITIES
760 3RD AVENUE SW,STE 110
CARMEL,IN 46032
I
i ( €
JEFF COOPER Net 30
•
DESCRIPTION
•
LIFT STATION @ HAZEL DELL LANDING PARK
CORE DRILLED 4"DIA.HOLE THRU 21"DEEP CONCRETE 300.00 300.00
WALL WITH DOUBLE MAT OF 1" REBAR
I
E
€
S
€ s
• �t
• ii
I
The Concrete Surgeons
assume no habililty whatso-
ever for layout of wall/ Thank you for your business I
floor openings,holes or
lines,or for cutting any
buried electrical,gas or j
} water-sewer lines. TOTAL $300.00
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
00353052
CONCRETE SURGEONS Purchase Order No.
4761 INDUSTRIAL PARKWAY Terms
INDIANAPOLIS, IN 46226 Due Date 8/21/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/21/2013 30821 $300.00
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
Date Officer
VOUCHER # 136220 WARRANT # ALLOWED
00353052 IN SUM OF $
CONCRETE SURGEONS
4761 INDUSTRIAL PARKWAY
INDIANAPOLIS, IN 46226
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
30821 01-7363-06 $300.00
Voucher Total $300.00
Cost distribution ledger classification if
claim paid under vehicle highway fund