192915 12/15/2010 CITY OF CARMEL, INDIANA VENDOR: 360381 Page 1 of 1
ONE CIVIC SQUARE SANTAROSSA MOSAIC TILE CO INC CHECK AMOUNT: $825.00
CARMEL, INDIANA 46032 PO BOX 664043
INDIANAPOLIS IN 46266 -4043 CHECK NUMBER: 192915
CHECK DATE: 12/15/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1093 4350100 1011048 825.00 BUILDING REPAIRS MA
i
SANTAROSSA TILE CO., INC INVOICE
TILE TERRAZZO— MARBLE PRECAST TERRAZZO CARPET —VINYL TILE
PHONE: (317) 632 -9494 FAX (317) 631 -5567
www.santarossa.com 11-15-10 589 10110 4 8
REMIT TO: SANTAROSSA MOSAIC TILE CO., INC.
P.O. Box 664043
Indianapolis, IN, 46266 -4043 23803 10110 4 8
Wi CARMEL CLAY PARKS RECREATION 1 -4600 $519.00
ATTN: SUSAN BEAURAIN 10106 JS
1411 EAST 116TH STREET 3 -4600 $246.00
CARMEL, INDIANA 46032
TERMS: NET 30 DAYS
RE: PO# 23803
I
1
JOB COMPLETE PER PO# 23803 FOR THE SUM OF: 825.00
Purchase s
Description
P.O. P P r p
G.L. IM3 3
LLine Descr NOV 17 20110
Purchaser Date
Approval Dat (0 �.a
PLEASE PAY THIS AMOUNT: 825.00
Late payments will be subject to late charges of 1 interest per month and reasonable attorney fees for Santarossa should the matter be placed with an attorney for collection.
DIRECT ALL NON PAYMENT CORRESPONDENCE TO: SANTAROSSA MOSAIC TILE CO, INC. P.Q. BOX 18181 INDIANAPOLIS, IN 46218
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of 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.
360381 Santarossa Mosaic Tile Co., Inc. Terms
P.O. Box 664043
Indianapolis, IN 46266 -4043
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
11/15/10 1011048 Threshold of locker rooms 23803 825.00
Total 825.00
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,
360381 Santarossa Mosaic Tile Co., Inc. Allowed 20
P.O. Box 664043
Indianapolis, IN 46266 -4043
In Sum of
825.00
ON ACCOUNT OF APPROPRIATION FOR
109 Monon Center
PO# or INVOICE NO. ACCT #rTITLE AMOUNT Board Members
Dept
1093 1011048 4350100 825.00 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
9 -Dec 2010
�w
Signature
825.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund