176399 08/19/2009 CITY OF CARMEL, INDIANA VENDOR: 00352389 Page 1 of 1
ONE CIVIC SQUARE R.A. ROSS ASSOCIATES INC
e CHECK AMOUNT: $326.70
CARMEL, INDIANA 46032 Po sox 247
SIMPSONVILLE KY 40067 CHECK NUMBER: 176399
CHECK DATE: 8/19/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCR
651 5023990 S11786 62722 326.70 FILTER
d
Invoice
REMIT TO:
R. A. ROSS AND ASSOCIATES INC.
P. 0. BOX 247 Invoice 62722
SIMPSONVILLE, KY. 40067 Customer: 8814
Inv Date:07.29.09
Page Num: 1
Order 9R1083
Bill -to: Ship -to:
CARMEL WASTEWATER TREATMENT PT CARMEL WASTEWATER TREATMENT
ATTN:ACCOUNTS PAYABLE 9609 HAZEL DELL PARKWAY
9609 HAZEL DELL PARKWAY INDIANAPOLIS, IN.
TNDIANAPOLTS, TN. 46280 46280
Customer PO Number:S11786
Ship Date Terms :Ship Via :Slspr Num:Due Date
07.29.09 :NET 30 :UPS 12 :08.28.09
Qty Ordered :Qty Shipped:Item Number :Unit :T: Extended
:Qty Backord:Description :Price :X: Amount
10 10 1- 0701 1151 -1020
0 3 /4 "FTLTER /200 MICRON 30.80000 N 308.00
R. A. ROSS AND ASSOC. (2009) Subtotal 308.00
2231 -A AMPERE DR. Sales Tax 0.00
LOUISVILLE, KY 40299 Inbound /Outbound Ereight 18.70
Invoice Total: 326.70
PHONE: 502.267.8677 Payment 0.00
FAX: 502.266.7928 Balance 326.70
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
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 8/10/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/10/2009 62722 $326.70
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 096155 WARRANT ALLOWED
352389 IN SUM OF
R.A. ROSS ASSOCIATES
PO BOX 247
Simpsonville, KY 40067
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
If
Board members
PO INV ACCT AMOUNT Audit Trail Code
62722 01- 7202 -06 $308.00
62722 01- 7202 -06 $18.70
Voucher Total $326.70
Cost distribution ledger classification if
claim paid under vehicle highway fund