HomeMy WebLinkAbout180047 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