227455 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 367785 Page 1 of 1
ONE CIVIC SQUARE ONPOINT CONSTRUCTION MANAGEMECHECK AMOUNT: $11,838.00
CARMEL, INDIANA 46032 INDIANAPOLIS 462 3
CHECK NUMBER: 227455
CHECK DATE: 12/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1202 R4340400 25874 1127 5, 000 . 00 FIBER INSTALLATION
1202 R4341955 26346 1127 5, 000 . 00 UNDERGROUND CONDUIT
1202 4341955 31634 1127 1, 838 . 00 US 31 CONDUIT RELOCAT
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CONSTRUCTION MANAGEMENT
1728 Churchman Ave.
Indianapolis, IN 46203
City of Carmel
Terry Crockett
1 Civic Square
Carmel, IN 46032
Invoice 1127
Route Construction
Invoice Date 12/01/2013 Footage Charges
�t`'r�itm> dui a � ��I„.- s, �';�
Fiber Connections to the following site:
Relocation Main St crossing 31
Constructure Services 1 -1.25”ID 1500 11,838
Total $11,838
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Quote
No Sales Tax applied-please send Tax Exempt-fax to 317-602-3627
PRICE DOES NOT INCLUDE FRANCHISE FEES
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Notes:
Call 317-289-9588 with questions.
Thanks,
Andy Purcell
INDIANA RETAIL TAX EXEMPT PAGE City ®f Carmel CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
JJJIII .
FEDERAL EXCISE TAX EXEMPT
35-60000972 31634
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES,A/P
CARMEL, INDIANA 46032-2584 VOUCHER, DELIVERY MEMO, PACKING SLIPS,
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL- 1997 SHIPPING LABELS AND ANY CORRESPONDENCE.
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
12/412013 US 31 Conduit Relocate
OnPoint Construction Management Carmel Communications
SHIP Terry Crockett
t I%
VENDOR 1726 Churchman Ave TO 3 Civic Square /
Indianapolis, IN 46203 Carmel, IN 46032
(317)571-2567
CONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Account 43.419.55
1 Each US 31 Conduit Relocation $1,838.00 $1,838.00
Sub Total: $1,838.00
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Send Invoice To:
City of Carmel
Terry Crockett
3 Civic Square
Carmel, IN 46032- PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
Carmel IS Dept. PAYMENT $1,636.00
• A/P VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O.
NUMBER IS MADE A PART OF THE VOUCHER AND EVERY INVOICE AND
VOUCHER HAS THE PROPER SWORN AFFIDAVIT ATTACHED.
SHIPPING INSTRUCTIONS I HEREBY CERTIFY THAT THERE IS AN.UNOBLIGATED BALANCE IN
•SHIP REPAID.
THIS APPROPRIATION SUF,IGIENT TO PAY FOR THE ABOVE ORDER.
•C.O.D.SHIPMENTS CANNOT BE ACCEPTED. ORDERED BY
•PURCHASE ORDER NUMBER MUST APPEAR ON ALL //
SHIPPING LABELS. �'� DlPectoP
•THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
q CLERK-TREASURER
DOCUMENT CONTROL NO. 316 3-11? A.P,V. COPY-SIGN AND RETURN TO CLERK'S OFFICE
VOUCHER NO. WARRANT NO.
ALLOWED 20
_.- IN THE SUM OF$
• t
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I 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
20
------......._............._-........--......_............----........_......................_..............-......_................................................--........................--.............
Signature
..................-........_..............................................-.._-.....................................................-........--.........--............._.._.................--.......
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
VOUCHER NO. WARRANT NO.
ALLOWED 20
OnPoint Construction Management
IN SUM OF $
1728 Churchman Ave
Indianapolis, IN 46203
$11,838.00
ON ACCOUNT OF APPROPRIATION FOR
IS Department
PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Encumbered I hereby certify that the attached invoice(s), or
25874 I 1127 43-404.00 $5,000.00
Encumbered bill(s) is (are) true and correct and that the
26346 1127 43-419.55 $5,000.00
materials or services itemized thereon for
31634 1127 43-419.55 $1,838.00_ which charge is made were ordered and
received except
Wednes December 11, 2013
Director , IS
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
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))
12/01/13 1127 $5,000.00
12/01/13 1127 $5,000.00
12/01/13 1127 $1,838.00
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