243577 03/24/15 J`/ �• CITY OF CARMEL, INDIANA VENDOR: 360381
ONE CIVIC SQUARE SANTAROSSA MOSAIC &TILE CO INC CHECK AMOUNT: $......*948.00*
i ,? CARMEL, INDIANA 46032 2707 ROOSEVELT AVE CHECK NUMBER: 243577
+M,...._.� INDIANAPOLIS IN 46218 CHECK DATE: 03/24/15
«ON�
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1093 4350100 1503010 948.00 BUILDING REPAIRS & MA
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Santarossa Mosaic&Tile Co, Inc. 7MA 2015
2707 Roosevelt Ave
Indianapolis, IN 46218
(317)632-9494
Carmel Clay Parks&Recreation INVOICE ID: 1503010
1411 E 116th ST DRAW ID: 1503010
Carmel, IN 46032 DATE: March 12.2015
SALESPERSON:
CONTRACT ID: 15207-01 CUSTOMER ID: CAR-007
Monon Comm Ctr Tile Repair PO#: 38135
_LOCATION:- --- -
Item Description Contract Percent Total Previous Total This
Id Amount Complete Billed Billed Invoice
0010 Ceramic Floor Tile Repair 948.00 100.00 % 948.00 948.00
Total 948.00 100.00%1 948.00 1 948.00
Contract Summary
Original contract amount 948.00
Approved changes 0.00
Revised contract amount 948.00
Invoiced to date 948.00
Remaining to invoice 0.00
Percent billed 100.00 %
Retainage balance 0.00
Approved by:
Name:
Title: -
Date:
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ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service,where �erformed, dates service rendered b
P Y
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
360381 Santarossa Mosaic&Tile Co., Inc. Terms
P.O. Box 18190
Indianapolis, IN 46218
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
3/12/15 1503010 Ceramic tile repair Women's shower stall 38139 $ 948.00
Total. $ 948.00
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
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Voucher No. Warrant No.
360381 Santarossa Mosaic&Tile Co., Inc. Allowed 20
Indianapolis, IN 46218�J
a'Z07 eose✓�-� K� i In Sum of$
$ 948.00
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ON ACCOUNT OF APPROPRIATION FOR
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109 -Monon Center
PO#or Board Members
Dept INVOICE NO. CCT#/TITL AMOUNT
'1093 1503010 4350100 $ 948.00 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
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I March 19, 2015
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Signature
$ 948.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
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