177818 09/29/2009 CITY OF CARMEL, INDIANA VENDOR: 00352389 Page 1 of 1
ONE CIVIC SQUARE R.A. ROSS ASSOCIATES INC
(i t l CHECK AMOUNT: $64.00
CARMEL, INDIANA 46032 S MPSSONVILLE KY 40067
CHECK NUMBER: 177818
CHECK DATE: 9/29/2009
DEPARTMEN ACCOUNT PO NUMBER INVO NUMBER AMOUNT DESCRIPTION
651 5023990 63022 64.00 MATERIALS SUPPLIES
Invoice
REMIT TO:
R. A. ROSS AND ASSOCIATES INC.
P. 0. BOX 247 Invoice 63022
SIMPSONVILLE, KY. 40067 Customer: 7609
Inv Date:09.14.09
Page Num: 1
Order 9R1330
Bill -to: Ship -to:
CITY OF CARMEL {IN} CITY OF CARMEL
ATTN: ACCOUNTS PAYABLE 9609 HAZEL DELL PARKWAY
9609 HAZEL DELL PARKWAY CARMEL, IN.
CARMEL, IN. 46280 46280
Customer PO Number:JEFF COOPER
Ship Date Terms :Ship Via :Slspr Num:Due Date
09.09.09 :NET 30 :PPA 12 :10.14.09
Qty Ordered :Qty Shipped:Item Number :Unit :T: Extended
:Qty Backord:Description :Price :X: Amount
1 1 81 -41- 4000 -0437
0 2" HOUSING SEAL 8.000000 Y 8.00
1 1 11- 2021 -4000
0 CLOG INDICATOR KIT 44.00000 Y 44.00
12 12 INDIANA FREIGHT TAX
0 IN.FREIGHT IS TAXABLE 1.000000 Y 12.00
R. A. ROSS AND ASSOC. (2009) Subtotal
2231 -A AMPERE DR. Sales Tax 4.48
LOUISVILLE, KY 40299 Inbound /Outbound Freight 0.00/
Invoice Total: 68.48
PHONE: 502.267.8677 Payment 0:00
FAX: 502.266.7928 Balance .48
Tax ID 61-1135021
After 30 days, unless otherwise specified, purchaser agrees to pay service
charge of 1 1/2o per month (18o per yr.) on unpaid balance (except where
prohibited by state law) plus reasonable attorney's fee in event of suit.
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER r
CITY OF CARMEL
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
352389
R:A. ROSS ASSOCIATES Purchase Order No.
PO BOX 247 Terms
Simpsonville, KY 40067 Due Date 9/21/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/21/2009 63022 $64.00
�r
hereby certify that the attached invoice(s), or bill(s) is (are) true and
.orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
VOUCHER 096443 WARRANT ALLOWED
352389 IN SUM OF
R.A, ROSS ASSOCIATES
PO BOX 247
Simpsonville, KY 40067
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
63022 01- 7202 -06 $64.00
Voucher Total $64.00
Cost distribution ledger classification if
claim paid under vehicle highway fund