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Home My WebLink About180047 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 074580 Page 1 of 1 ONE CIVIC SQUARE DEPT OF INTERIOR -USGS t CHECK AMOUNT: $3,150.00 CARMEL, INDIANA 46032 PO BOX 70934 CHAROLTTENC 28272 -0934 CHECK NUMBER: 180047 CHECK DATE: 12/8/2009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 609 5023990 9-- 2412 -00051 3,150.00 1050.05 Form DI -1040 IN005 a United States Bill No: 9- 2412 -00 Department of the Interior Bill Date: 10/08/2009 Geological Survey Due Date: 12/07/2009 BILL FOR COLLECTION Mail Check To: DOf USGS BOX 70934 CHARLOTTE NC 28272 -0934 Customer Address: Send Overnioht/Express Mail To: a City of Carmel, Carmel Utilities IN005 QLP Wholesale Lockbox NC 0810 Attention: John Duffy Lockbox 70934 760 Third Avenue S.W. 1525 West WT Harris Blvd Charlotte, NC 28262 Carmel, IN 46032 Checks must be made pay able to. DOI -USGS and must include a copy of this bil or refe th No a bove. Notice Payments to USGS may be made b all major credit cards, either by email to USGS address: gdatta @usgs.gov OR by phone (703.648.7605). i Description: Quantity i Unit Price Unit Issue Amount Expenses incurred with the City of Carmel for the maintenance and I $3,150.00 EA $3,150.00 observation of wells in Carmel for the period of October 1, 2008 to September 30, 2009. Federal Regulations require Interest at the annual rate of 3 (0.25% /month) be assessed from the date of this bilt if payment is not received by the Due Date. Regulations also require that a Penalty at the rate of 6 %n (.5% /month) be assessed from the date of (he bill if this bill becomes 90 days delinquent. No interest will be charged if payment is made by the due date I certify that this bill is correct, in accordance with the terms of the order /signed agreement, and payment has not been received. Tonja R Clark Prepared by: Tonja R Clark 317- 290 -3333 Amount Due This Bill: $3,150.00 x123 USGS ACCOUNTING CLASSIFICATION SECTION: Reimbursable Ag reement BFY F;FY Cust# IN005 Amount Fund Rev Src Co Cent 09E41N2412020 2009 2010 $3,150.00 SIRTR ARJF 2412 $3,150.00 *'Total Routing Slip: Created By: Tonja R Ciark Supervisor: OFAI Contact: Denis J Sheehan /APS /USGS /DOI 703 648 -7642 CC: Damien M Oris TIN:356000972 10/08/2009 Prescribed by State Board of Accounts City Form No. 201 (Rev 199�'-- ACCOUNTS PAYABLE VOUCHEk CITY OF CARMEL t' An invoice or bill to be properly itemized must show, kind of service, where performed, dates of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 74580 USES DEPT OF THE INTERIOR Purchase Order No. Water Resources Division Terms 5957 Lakeside Blvd Due Date 12/2/2009 Indianapolis, IN 46278 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 12/2/2009 9241200051 $3,150.00 I 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 Date OfIlter VOUCHER 093769 WARRANT ALLOWED 74580 -DO IN SUM.OF USGS DEPT OF THE INTERIOR Water Resources Division 5957 Lakeside Blvd Indianapolis, IN 46278 Carmel Water Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 9241200051 07- 1050 -05 $3,150.00 C r Voucher Total $3,150.00 Cost distribution ledger classification if claim paid under vehicle highway fund