HomeMy WebLinkAbout178671 10/28/2009 CITY OF CARMEL, INDIANA VENDOR: 074580 Page 1 of 1
ONE CIVIC SQUARE DEPT OF INTERIOR -USGS
ti?ja. CARMEL, INDIANA 46032 PO BOX 70934 CHECK AMOUNT: $3,600.00
CHAROLTTE NC 28272 -0934 CHECK NUMBER: 178671
CHECK DATE: 10/28/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DE
206 4462838 9- 2412 -00038 3,600.00 STORM WATER PHASE II
t-
Form DI -1040 IN005
United States 11 Bill No: 9- 2412 -00038
Department of the Interior Bill Date: 10/07/2009
Geological Survey Due Date: 12/06/2009
l Check To:
$ILL FOR COLLECTION M
uses
BOX 70934
i
CHARLOTTE NC 28272 -0934
Customer Address Send Overni Mail To:
City of Carmel IN005 QLP Wholesale Lockbox NC 0810
Attention: Mike McBride, Dept of Engineering Lockbox 70934
One Civic Square 1525 West WT Harris Blvd
Charlotte, NC 28262
Carmel, IN 46032
Checks must be made pa to: DOI -USGS and must
include a co of this bill or reference the Bill No above.
Notice: Payments to USGS may be made by all major credit cards, either by email
to USGS address: gdatta @usgs.gov OR by phone (703.648.7605).
Description: Quantity Unit Price Unit Issue Amount II 1 11
Expenses incurred with the City of Camel for operation and 1 $3,600.00 EA $3,600,00
maintenance of the gage station on Williams Creek at 96th Street in
Hamilton County for the period of October I, 2008 to September
30, 2009.
Federal Regulations require Interest at the annual rate of 3 %n (0.25% /month) be assessed from the date of this bill if payment is
not received by the Due Date. Regulations also require that a Penalty at the rate of 6% (.5% /month) be assessed from the date of
the 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: $8,600.00
x1.23
USGS ACCOUNTING CLASSIFICATION SECTION:
Reimbursable
Ag BFY EFY Cust# IN005 Amount Fund Rev Sre Cost Center
09E41N2412004 2009 2010 $3,600.00 SIRTR ARJF 2412
$3,600.00 *Total
Routing Slip:
Created By: Tonja R Clark
Supervisor:
OFM Contact: Denis J Sheehan /APS /USGS /DOT 703- 648 -7642
CC: Damien M Oris TIN:35600972
10/07/2009
;prescribed by State Board of Accounts City Form No. 201 (Rev. 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
,AbQ§er day, number of hours, rate per hour, number of units, price per unit, etc.
Box 70934 Payee
Purchase Order No.
ar o e,
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
9 -2412 -00038 St reannflow Gaging Station Williams Uree
installation, Operation, Main enance
Total
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.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
DOI -USGS IN SUM OF
Box 70934
Charlotte, NC 28272 -0934
$3,600.00
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
Po# or INVOICE NO. ACCT #[TITLE AMOUNT
WEPT 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
CA -2 20
Signature
Enc �\VV -Q -S-V
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund