187267 07/07/2010 CITY OF CARMEL, INDIANA VENDOR: 068025 Page 1 of 1
ONE CIVIC SQUARE CROSSROAD ENGINEERS, PC CHECK AMOUNT: $30,491.20
CARMEL, INDIANA 46032 3417 S SHERMAN DR
BEECH GROVE IN 46107 CHECK NUMBER: 187267
CHECK DATE: 7/7/2010
DEPARTMENT ACCO P O NUMBER INVOI NUMBE AMOUNT DESCRIPTION
203 4462200 10340 28,862.20 SIDEWALK IMPROVEMENTS
1205 4462862 10341 1,629.00 HAZEL DELL ROAD IMPRO
MKS
CrossRoad Engineers, PC
3417 Sherman Drive
Beech Grove, IN 46107
317 -780 -1555
City of Carmel Invoice number 10341
Michael McBride, City Engineer Date 06/03/2010
1 Civic Square Page number 1
Carmel, IN 46032 Project: HAZEL DELL PARKWAY IMPROVEMENTS
For services performed May 1.through May 28, 2010
PROMPT PAYMENT OF INVOICE IS APPRECIATED!!
These services were provided in accordance with our contract #03.03.10.03 approved March 3, 2010 and
Additional Services
Local Inspection
Professional Fees
Billed
Hours Rate Amount
Director 6.00 125.00 750.00
Resident Project Engineer 9.00 95.00 855.00
Reimbursables
Billed
Units Rate Amount
Miles 50.00 0.48 24.00
Phase subtotal 1,629.00
total 1,629.00
Invoice total 1,629.00
Th Y u!
t
Chip Charl s I t
President
City of Carmel Invoice number: 10341 Invoice date: 06103/2010
J. tart
CrossRoad Engineers, PC
3417 Sherman Drive
Beech Grove, IN 46107
317 -780 -1555
City of Carmel Invoice number 10340
Michael McBride, City Engineer Date 06/03/2010
1 Civic Square Page number 1 of 2
Carmel, IN 46032 Project: 106TH STREET PATH KEYSTONE TO
WESTFIELD 0
For services performed May 1 through May 28, 2010 d
PROMPT PAYMENT OF INVOICE IS APPRECIATED!!
These services were provided in accordance with our contract #03.03.10.03 approved March 3, 2010 and
Additional Services
Inspection
Professional Fees
Billed
Hours Rate Amount
Director 17.50 125.00 2,187.50
Project Engineer 82.00 85.00 6,970.00
CADD Technician 14.50 70.00 1,015.00
Resident Project Engineer 116.00 95.00 11,020.00
Reimbursables
Billed
Units Rate Amount
Miles 1,041.00 0.48 499.68
Phase subtotal 21,692.18
total 21,692.18
Construction Staking
Professional Fees
Billed
Hours Rate Amount
CADD Technician 5.00 70.00 350.00
Survey Manager 7.50 95.00 712.50
Crew Chief 43.50 80.00 3,480.00
Field Man 43.00 60.00 2,580.00
Reimbursables
Billed
Units Rate Amount
Miles 99.00 0.48 47.52
Phase subtotal 7,170.02
City of Carmel Invoice number: 10340 Invoice date: 06/03/2010
City of Carmel Invoice number 10340
Date 06103/2010
Page number 2 of 2
Project: 106TH STREET PATH KEYSTONE TO
WESTFIELD
tota 1 7,170.02
Invoice total 28,862.20
Tha u!
Chi hares, E. t
President
City of Carmel Invoice number: 10340 Invoice date: 06/03/2010
m INDIANA RETAIL TAX EXEMPT PAGE
ulty Carmel CERTIFICATE NO. 0031 201 55 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 2 l 0
35- 60000972
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, A/
CARMEL, INDIANA 46032 -2584 VOUCHER, DELIVERY MEMO, PACKING SLIP;
=ORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997 SHIPPING LABELS AND ANY CORRESPONDENCE
RCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR N0. DESCRIPTION
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IENDOR SHIP
TO
NFIRMATION BLANKET CONTRACT PAYMENTTERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send Invoice To:
12-0 r— ?_°td:A�v 2 %i" X22
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT AMOUNT
PAYMENT
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 SUFFICIENTTO PAY FOR THE ABOVE ORDER.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
2 1 81 6 CLERK- TREASURER
)OCUMENT CONTROL NO. VENDOR COPY
m INDIANA RETAIL TAX EXEMPT PAGE
kAty Carm CERTIFICATE N 002 0 I PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT �7 k C.
35- 60000972 L l
ONE CIVIC SQUARE THIS NUMBER MUST APPEAR ON INVOICES, R
CARMEL, INDIANA 4fiO32 2584 VOUCHER, DELIVERY MEMO, PACKING SLIF
SHIPPING LABELS AND ANY CORRESPONDENC
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL 1997
1RRCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
J o
VENDOR ToIP
:ONFIRMATION BLANKET CONTRACT PAYMENT TERMS FREIGHT
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
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Send. Invoice To: t �t ~__r
7 Ls,
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PLEASE INVOICE IN [DUPLICATE I to
DEPARTMENT ACCOUNT PROJECT PROJECT ACCOUNT AMOUNT
PAYMENT
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
THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
SHIP REPAID.
C.O.D. SHIPMENTS CANNOT BE ACCEPTED.
PURCHASE ORDER NUMBER MUST APPEAR ON ALL ORDERED BY
SHIPPING LABELS.
THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99, ACTS 1945 TITLE
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO.
CLER K-TREASURER
Mr.11M IFNT CONTROL NO_ VENDOR COPY
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
Crossroad Engineers
Purchase Order No.
3417 S. Sherman Dr.
Terms
Beech Grove, IN 46107
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
06/03/10 10341 Hazel Dell 131st- Cherry Tree Inspection $1,629.00
06/03/10 10340 106th St. Path Inspection Keystone Westfield $28,862.20
Tot
IP" 3a, I, 2-c
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
Crossroad Engineers IN SUM OF
3417 S. Sherman Dr
Beech Grove, IN 46107
1 30 491.210
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
r 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
103 40 299 462299 wni6r charge is made were ordered and
received except
20
Si natur
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund