226278 11/19/2013 CITY OF CARMEL, INDIANA VENDOR: 367636 Page 1 of 1
ONE CIVIC SQUARE DALLMAN CONTRACTORS
CARMEL, INDIANA 46032 5808 W.74TH STREET CHECK AMOUNT: $18,657.00
INDIANAPOLIS IN 46278 CHECK NUMBER: 226278
CHECK DATE: 11/19/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2201 4350900 31259 10340 18 , 657 . 00 KESTONE BRIDGE MAINTE
Dallman Contractors, LLC Invoice
Date Invoice #
5808 W. 74th Street 11/11/2013 10340
Bill To Job Site
City of Carmel Keystone Bridges Concrete Maintenance
Street Department
3400 W. 131 st Street
Carmel, IN 46074
P.O. No. Terms Due Date Rep Project
31259 Net 30 12/11/2013 RB Job 13087 Keystone Bridges Maintenance
Item Description Est Amt Prior Amt Prior% Curr% Total % Amount
Contract Labor and materials to complete 74,357.00 55,700.00 74.91% 25.09% 100.00% 18,657.00
the maintenance to the Keystone
Bridges per Dallman's proposal
submitted 9/18/13.
Total $18,657.00
All Applicable Taxes Are Paid in Full Payments/Credits $0.00
Balance Due $18,657.00
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11/11/13 10340 $18,657.00
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 NO. WARRANT NO.
ALLOWED 20
Dallman Contractors, LLC
IN SUM OF $
5808 W. 74th Street
Indianapolis, IN 46278
$18,657.00
ON ACCOUNT OF APPROPRIATION FOR
Carmel Street Department
PO#/Dept. INVOICE NO. ACCT#/TITLE I AMOUNT Board Members
31259 I 10340 I 43-509.001 $18,657.00 1 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
received except
1 i
"/Thurs 013
I - U
ommissloner
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund