226804 12/03/2013 CITY OF CARMEL, INDIANA VENDOR: 367666 Page 1 of 1
ONE CIVIC SQUARE SAGAMORE READY MIX LLC
€ CHECK AMOUNT: $1,116.25
' CARMEL, INDIANA 46032 9170 EAST 131ST ST
FISHERS IN 46038 CHECK NUMBER: 226804
CHECK DATE: 12/312013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
2200 4462300 434629 1, 116 . 25 DRAINAGE IMPROVMTS
SAGAMORE READY MIX, LLC
9170 East 131st Street - Fishers, IN 46038
Phone: (317) 570-6201 - (888) 986-9293
PAGE 1
CUSTOMER # 1550
Invoice Date 11-08-2013
Invoice Number 434629
CITY OF CARMEL Order Code 99
One. O Vic 5 01(6 Project Code
�ormd 1tv Purchase Order
Job Number
DELIVERY LOCATION PAYMENT TERMS
750 N RANGELINE ROAD DISC 10th TOTAL 20th AFTER DELIVERY MO
Ticket # Usage _ Product Product Quantity Price Extended
Code Description Amount
------------------------------------------------------------------------------------------------
791341 DRIVEWAY B6016 6 BAG STONE AIR 8 .50 cy 118.50 1, 007.25
791341 5015 SYNTHETIC FIBER (BLUE) 8.50 ea 7.00 59.50
791341 7001 WINTER CHARGE 8.50 /y 3.00 25.50
791341 4416 ENVIRO PER YARD 8 .50 ea 2 .00 17.00
791341 FUEL FUEL SURCHARGE 1.00 ea 7.00 7.00
-CONTACT KEITH MCDANIEL AT (317) 570-6228 FOR ANY BILLING QUESTIONS
YOU MAY DEDUCT $31.83 FROM THIS INVOICE IF PAID BY Dec-10-2013.
THIS REFLECTS ANY APPLICABLE TAX ADJUSTMENT ON YOUR CUBIC YARD DISCOUNT.
Total Yards Sub Total Sales ax INVOICE TOTAL
8.50 $1, 116.25 8.14 $1,194.39
,
9170 East 131St Street
Fishers, IN 46038-3545
(317) 570-6200 Dispatch
(888)986-92
(317) 570-62001 1 Office SAGAM O R E READY MIX, L LC
294994?'i (888)986-9293
09/13,r. (317) 570-6271 Fax
DELIVERY TICKET
I CAUTION:FRESHLY MIXED CONCRETE,MORTAR OR GROUT MAY CAUSE SKIN INJURY.AVOID CONTACT WITH SKIN AND WASH EXPOSED SKIN AREAS PROMPTLY
I WITH WATER.CONTAINS PORTLAND CEMENT.IF ANY MIXTURE OF CEMENT GETS INTO EYES,RINSE IMMEDIATELY AND REPEATEDLY WITH WATER AND GET
PROPER MEDICAL ATTENTION.SEE MSDS ON BACK OF CUSTOMER COPY.
KEEP CHILDREN AWAY FROM WET MIXES.
1. Customer is responsible for suitable roadway into and out of place of material delivery,and proper wash out location.
2. When delivery is requested off public roadways,customer assumes risk and is responsible for damages to sidewalks,driveway or other property.
0
3. We do not assume responsibility for slump,strength or quality of concrete when water or any other material is added by the purchaser or his representative,or
oat their request. Due to the fact that concrete is made from natural materials,color consistency from load to load cannot be guaranteed.
a 4. Purchaser understands that concrete not cured according to ACI 308 may only develop.50%of its designed strength.
. 5. Testing of delivered concrete must be done by ACI Level 1 Concrete Testing Technicians.
LL 6. Do not apply de-icing compounds to exterior concrete during its first winter.
}�. 7. We do not guarantee the finished surface results obtained from this load of concrete.Too many factors not under our control can affect the ultimate results.
w i Gallons Added Meter Reading Slump Ticket Number
o
7913x+1
Z `. 'r Date
U) .{ r
Ticket Number 08-'NOV-13
co Plant Order# Customer Number Project P.O.Number Job Name—Number
99 1550
o ;I Sold To: Delivery Address: kk{{t 8 ,
z CITY OF CARMEL 750 N RANGELINE ROAD
JUST S .OF 136TH ST (SNOKEY RIM RDj ON RANGELINE ,RD
0 �i?
CL
Received By: On Job
® 'i Load No. Slump(+i-I" Air Content t+i-iqt Meter Reading At Plant Meter Reading Upon Arriva Used For Ordered By
1 s 06.00 DRIVEWAY JIM 417-5 216
.tj Quantity . Quantity Quantity Product
This Load Ordered Delivered Code product Description Units Unit Price Amount
8.50 8.50 8.50 96016 6 BASS STONE AIR Cy
®N I 8.50 5015 SYNTHETIC.FIBER (BLUE) " ea
[tfill f
.� FUEL SUR ENUIRON SUB-TOTAL
a TNr R SALES TAX
Truck No. Delivered By Left Plant Arrived Job Left Job
TICKET TOTAL
365 30085 WARREN;. A CJ• °°�p l ORDER TOTAL
VL
. I •fit. T
lee-
- 11 Office-White Customer Coov- Blue Plant Coov-Yellow Customer Coov-Green r>
4
r
JANUARY 25, 2013 II
k
MATERIAL SAFETY DATA SHEET HEALTH HAZARD DATA
MANUFACTURER:SAGAMORE READY MIX,LLC ROUTES OF ENTRY:INHALATION:N/A SKIN:YES INGESTION:N/A t
IN CASE OF EMERGENCY CALL:317.570.6200 ACUTE HEALTH HAZARDS:CONTACT DERMATITIS AND/OR SEVERE r •
IDENTITY OF MATERIAL:READY MIXED CONCRETE AND FLOWABLE BURNS POSSIBLE WITH PROLONGED OR REPEATED CONTACT
FILL WITH UNPROTECTED SKIN WHEN PRODUCT IS IN THE
HAZARDOUS INGREDIENTS:AQUEOUS MIXTURE OF CALCIUM UNHARDENED STATE. rt
SILICATES,ALUMINATES,AND FERRiTES,PORTLAND AND BLENDED CHRONIC HEALTH HAZARDS:HYPERSENSITIVE INDIVIDUALS MAY
CEMENTS: DEVELOP AN ALLERGIC DERMATITIS WITH REPEATED CONTACT
3CaO.S10(CAS 12168-85-3) WITH PRODUCT IN THE UNHARDENED STATE. j
2CaO.S10(CAS 10034-77-2) CARCINOGENICITY:NONE KNOWN
3CaO.A1:0(CAS 23042-78-3) SIGNS/SYMPTOMS OF OVEREXPOSURE:IRRITATION ANDlOR f •
4CaO.A1.FE:0(CAS 12068-35-8) y BURNING OF SKIN OR EYES.
CaSO4,21-12 {CAS 7778-18-9)PLUS TRACES OF CaO,MgO, PRECAUTIONS FOR SAFETY HANDLING&•USE:USE PROPER TOOLS
K2SO4&N62SO4 AND EQUIPMENT.RUBBER BOOTS,RUBBER GLOVES AND I
OTHER INGREDIENTS:CONCRETE AGGREGATES,INERT GRAVEL, PROTECTIVE CLOTHING COVERING ARMS AND LEGS SHOULD BE
SAND AND ROCK. WORN.PERSONS WITH SENSITIVE SKIN SHOULD TAKE EXTRA ,
ADMIXTURES:MAY INCLUDE FLY ASH,GRANULATED SLAG,AND PROTECTIVE PRECAUTIONS •
VERY SMALL AMOUNTS OF ORGANIC AND INORGANIC MATERIALS EMERGENCY AND FIRST AID PROCEDURES:CONTACT WITH EYES:
WHICH HAVE NO EFFECT ON THE HAZARDS ASSOCIATED WITH' IMMEDIATELY FLUSH EYES WITH COPIOUS AMOUNTS OF WATER ' 6
USE OF PRODUCT. } AND CONSULT A PHYSICIAN.CONTACT WITH SKIN:THOROUGHLY
PHYSICAL/CHEMICAL CHARACTERISTICS: WASH AFFECTED AREA WITH SOAP AND WATER.A PHYSICIAN j
BOILING POINT N/A SHOULD BE CONSULTED FOR SEVERE BURNS OR PERSISTENT i
VAPOR PRESSURE:N/A IRRITATION.,
VAPOR DENSITY.•N/A I •
SPECIFIC GRAVITY. +/-2.30 THE INFORMATION HEREIN IS GIVEN IN GOOD FAITH AND IS BASED
FIRE/EXPLOSION DATA:N/A ON KNOWLEDGE BELIEVED TO BE RELIABLE.NO WARRANTY,
REACTIVITY'DATA:STABLE EXPRESSED OR IMPLIED,IS GIVEN REGARDING THE ACCURACY OF
MELTING POINT N/A THIS DATA OR THE RESULTS OBTAINED FROM THE USE THEREOF. ; •
EVAPORATION RATE:N?A
SOLUBILITY:SIGHT(0.01 TO 1%)
APPEARANCE&ODOR:GRAY,PLASTIC,FLOWABLE,
GRANULAR MUD,ODORLESS i
HAZARDOUS POLYMERIZATION:NONE
WARNING:INJURIOUS TO EYES:CAUSES SKIN IRRITATION:READ THIS WARNING BEFORE USING:CONTAINS PORTLAND �
CEMENT. !
Contact with wet,unhardened concrete,mortar,cement or cement mixtures can cause skin irritation,severe chemical burns or serious •
eye damage.Avoid contact with eyes and skin.Wear waterproof gloves, a fully buttoned, long-sleeve shirt,full length trousers and
tight-fitting eye protection when working with these materials. If you have to stand in wet concrete, use waterproof boots that are
tight at the top and high enough to keep concrete from flowing into them. If you are finishing concrete,wear kneepads to protect 1
knees.Wash wet concrete,.mortar,cement or cement mixtures from your skin With fresh,clean water immediately after contact.
Indirect contact through clothing can be as serious as direct contact, so promptly rinse wet concrete, mortar, cement or cement
mixtures from clothing. Seek immediate medical attention if you have persistent or severe discomfort. In case of eye contact,flush j
with plenty of water for at least 15 minutes.Consult a physician-immediately.KEEP OUT OF REACH OF CHILDREN.USER AGREES
TO CONVEY THIS WARNING TO ALL PERSONS WHOM MAY USE OR COME INTO CONTACT WITH WET(UNHARDENED)
CONCRETE, MORTAR,AND CEMENT OR CEMENT MIXTURES.
CRYSTALLINE SILICA CARCINOGENIC POTENTIAL: Concrete frequently contains crystalline silica in concentrations greater than j •
0.1 percent, principally contributed by the aggregates. Respirable crystalline silica is classified by the International Agency for
Research on Cancer as a known human carcinogen and by the National Toxicology Program as"reasonably anticipated to be a •
carcinogen".Crystalline silica in wet concrete is not respirable and does not pose a hazard when the concrete is in its plastic or
unhardened state.Once concrete has hardened,airborne dust generated by grinding, sawing, drilling, breaking,etc.,can lead to
potentially hazardous exposures to workers and appropriate respiratory protection precautions should be taken. •
f
I
ILM'_i
i
i
w
lu, 9170 East 131St Street
.; Fishers, IN 46038-3545
1 (317) 570-6200 Dispatch
(888)986-9294 "
(317)570-6201 Office SAGAM®RE READY MIX, LLC
' 8 86-92
294994 ,. ( HH) 3 9 9
osn3•. I (317) 570-6271 Fax
DELIVERY TICKET
s} CAUTION:FRESHLY MIXED CONCRETE,MORTAR OR GROUT MAY CAUSE SKIN INJURY.AVOID CONTACT WITH SKIN AND WASH EXPOSED,SKIN AREAS PROMPTLY
i WITH WATER.CONTAINS PORTLAND CEMENT. IF ANY MIXTURE OF CEMENT GETS INTO EYES,RINSE IMMEDIATELY AND REPEATEDLY WITH WATER AND GET
j PROPER MEDICAL ATTENTION.SEE MSDS ON BACK OF CUSTOMER COPY.
KEEP CHILDREN AWAY1ROM WET MIXES.
®t " 1. Customer is responsible for suitable roadway into and out of place of maters la delivery, and proper wash out location.
-� 2. When delivery is requested off public roadways,customer assumes risk and,5s sporisible for damages to sidewalks,driveway or,other property.
w3. We do not assume resporvsibility for slump,strength or quality of concrete when water or any other material is added by the purchaser or his representative,or
W at their request. Dubst the fact that concrete is made from natural materials,,color consistency from load to load cannot be guaranteed.
a Y: 4. Purchaser understands that concrete not cured according to ACI 308 may o ly develop 50%of its designed strength.
6`� i .
r! 5. Testing of delivered concrete must be done by ACI Level 1 Concrete Testing Technicians.
LL c 6. Do not apply de icing compounds to exterior concrete during its first wigtel
{�-�5 - 7. We do not guarantee0e finished surface results obtained from this load o.concr�te.Too many factors not under our control canp�affect the ultimate results.
Gallons Added Meter Reading Slump Ticket Number
0
1 r
791341
Z y• Date
n ® Ticket Number J 1 �►B-Nav'-1.,3
Plant Order# Customer Number Project. P.O.'Number Job'Name'—Number
.5�: ' 5 99 1551 r
,k
Sold To. _ xs Delivery-Address -• ;i ;,
j CITY OF CARMEL 730 IN RANGELINE iMAD
° ;`{ JUST S OF 136TH ST-(SMOKEY ROW RED) ON RANGELINE /RD
Received B Y: _ on Job
Load No. Slump(-/-1,, Air Content,+i_iq! Meter.Reading At Plant `Meter Reading Upon Arriva ' Used-For Ordered By
i
< 1 3 06.00 DRIVEWAY JIM 417 75216
Quantity Quantity Quantity Product
This Load Ordered Delivered Code, Product Description Units Unit Price Amount
8.50 8.56 8.50 96016 6 BAG STONE AIR � Cy
5th 15 S'fIVT�IE�I C E" A� t$LtIEJ
1 mY'
` f
-A'`�� -
4, FUEL SUP. ENV'IRON SUB-TOTAL
WINTER SALES TAX
rra Truck No. Delivered By Left Plant Arrived Job Left Job
TICKET TOTAL
365 39.095 WARREN, R �' c� � � ORDER TOTAL
�; Office-White Customer-Coov- Blue Plant Coov-Yellow Customer.Co v-Green
JANUARY 25, 2013 - I
MATERIAL SAFETY DATA SHEET HEALTH HAZARD DATA
MANUFACTURER:SAGAMORE READY MIX,LLC ROUTES OF ENTRY:INHALATION:N/A SKIN:YES INGESTION:NIA I
IN CASE OF EMERGENCY CALL:317.570.6200:, ACUTE..HEALTH HAZARDS:CONTACT DERMATITIS ANDlOR SEVERE
IDENTITY OF MATERIAL:READY MIXED CONCRETE AND FLOWABLE BURNS POSSIBLE WITH PROLONGED OR REPEATED CONTACT
FILL WITH UNPROTECTED SKIN WHEN PRODUCT IS IN THE
HAZARDOUS INGREDIENTS:AQUEOUS MIXTURE OF CALCIUM UNHARDENED STATE. t
SIL wES,.ALUMINATES,AND FERRITES,;PORTLAND AND BLENDED CHRONIC HEALTH HAZARDS:HYPERSENSITIVE INDIVIDUALS MAY
CEMENTS: DEVELOP AN ALLERGIC DERMATITIS WITH REPEATED CONTACT
I
3CaO.S10(CAS 12168-85-3) WITH'PRODUCTN THE UNHARDENED STATE. j
2CaO.S10(CAS 10034-77-2) CARCINOGEN[CITY:NONE KNOWN •
3CaO.A1:0(CAS 23042-78-3) " ' SIGNS/SYMPTOMS OF OVEREXPOSURE:iRRITATION ANDlOR
4Ca0.A1.FE:O,(CAS'-1'2068-35 8) - BURNING OF SKIN OR EYES:
CaSO4;2112 (CAS*7778-1.8-9)1 PLUS TRACES OF CaO,MgO, PRECAUTIONS FOR SAFETY HANDLING,&USE:USEPROPER TOOLS
K2SO4&Na2SO4 " AND EQUIPMENT.RUBBER BOOTS,RUBBER GLOVES AND }
OTHER INGREDIENTS:CONCRETE AGGREGATES,INERT GRAVEL, PROTECTIVE CLOTHING COVERING ARMS AND LEGS SHOULD BE
SAND AND ROCK. WORN,PERSONS WITH SENSITIVEiSKIN SHOULD TAKE EXTRA
ADMIXTURES:MAY INCLUDE FLY ASH,GRANULATED SLAG,AND PROTECTIVE PRECAUTIONS •
VERY-SMALL AMOUNTS OF•ORGANIC AND INORGANIC MATERIALS ,, EMERGENCY AND FIRST AID PROCEYURES:CONTACT WITH EYES. ,
WKICH-HAVE dd EFFEuT ON THE i{AZPRDS•ASSOCIATED WITHH iiv1NIEDItai` Y i LUSti'EYES iNiTI r G-PIOUS AMOUNTS OF"WATER
USE OF PRODUCT. . - AND CONSULT`A PHYSICIAN.CONTACT WITH SKIN:-THOROUGHLY '
PHYSICAL/CHEMICAL CHARACTERISTICS: WASH AFFECTED.AREA.WITH SOAP, WATER.A:PHYSICIAN'
BOILING POINL N/A SHOULD BE CONSULTED FOR SEVRE BURNS OR PERSISTENT
VAPOR PRESSURE:NIA IRRITATION.
'VAPOR DENSITY.•N/A' t c _': _ _ f •
SPECIFIC GRAVITY.•+/-2.30 THE INFORMATION HEREIN IS GIVEN IN GOOD FAITH AND IS BASED {
FIREIEXPLO,SION.DATA:NIA__ -. _ ON KNOWLEDGE BELIEVED TO BE RELIABLE:NO WARRANTY,,
REACTIVITY"DATA:STABLE EXPRESSED OR IMPLIED, GIVEN REGARDING THE ACCURACY OF
MELTING POINT N/A THIS DATA OR THE RESULTS OBTAINED FROM.THE USE THEREOF' � •
EVAPORATION-RATE. N/A • _ _.--
SOLUBILITY SIGHT(0.01 TO 1%)
APPEARANCE&ODOR:GRAY;PLASTIC, FLOWABLE •
GRANULAR MUD,ODORLESS 1.
HAZARDOUS POLYMERIZATION:NONE
1 '�iI:
WARNING',INJURIOUS TO EYES:CAUSES SKIN IRRITATION: READ THIS WARNING BEFORE USING""CONTAINS PORTLAND
CEMENT.
Contact with wet,unhardened concrete, mortar,cement or cement mixtures can cause skin irritation,severe chemical burns or serious •
eye damage.Avoid-contact with eyes and,skin.Wear.waterprootgloves.,a fully.buttoned,.long-sleeve shirt;full length trousers and
tight-fitting eye protection when working with these materials. If you have to stand in wet concrete, use iVaterproof boots that are
tight at the-top'and high enough to.keep`concrete from.fiowing into them.lf,you are finishing concrete;wear kneepads to protect � •
knees.Wash wet concrete,-mortar,cement or cement mixtures from your skin with fresh,clean water immediately after contact.'
indirect contact through clothing can be as serious as direct contact,so promptly rinse wet concrete', mortar, cement.or cement
mixtures from clothing.Seek immediate medical attention iY you,have persistent or severe discomfort.Ini case of eye contact,fluski
,with plenty of.water for•at,Ieast 15 minutes:.Consuit,.a,oliysie} r.imrriediately:IEEE!?OLIT OF REAC¢i-O,F GH1L!7IREM.-USER AGREES 1 0
TO CONVEY THIS WARNING TO ALL,PERSONS WHOM MAY USE'OR COME INTO CONTACT WITH WET'(UNHIARDENED) '
CONCRETE, MORTAR,AND,CEMENT,OR CEMENT MIXTURES.
0
CRYSTALLINE SILICA CARCINOGENIC POTENTIAL:Concrete frequently contains crystalline silica in concentrations greater than 1
0.1 percent, principally contributed by the aggregates. Respirable crystalline silica is classified by the international Agency for j
Research on Cancer as a known human carcinogen and by the National Toxicology Program as"reasonably anticipated to be a i •
carcinogen Crystalline silica'in wet concrete is not respirable and does notipose a hazard when the concrete is in,its plastic or
unhardened state. Once eoncrete has hardened,airborne dust generated by•grinding, sawing, drilling; breaking,' etc.; can lead to
potentially hazardous exposures to workers and appropriate respiratory protection precautions should be taken.
on
1 T� f� t�'a •
iii, a '`\ �•�
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
Sagamore Ready Mix Purchase Order No.
9170 East 131st Street Terms
Fishers, IN 46038 Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s) Amount
111812013 434629 materials for North Rangeline repair $ 1,194.39
Totall $ 1,194.39
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.
Sagamore Ready Mix ALLOWED 20
9170 East 131st Street IN SUM OF $
Fishers, IN 46038
$ 1,194.39
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or
DEPT# INVOICE NO. ACCT#/TITL AMOUNT
DEPT# I hereby certify that the attached invoice(s),
0 434629 2200-4462300 $ 1,194.39 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
12/2/2013
c a
Signature
City Engineer
Cost Distribution ledger classification if Title
claim paid motor vehicle highway fund