173020 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 360381 Page 1 of 1
ONE CIVIC SQUARE SANTAROSSA MOSAIC TILE CO INC
CARMEL, INDIANA 46032 PO Box 664043 CHECK AMOUNT: $890.00
INDIANAPOLIS IN 46266 -4043
CHECK NUMBER: 173020
CHECK DATE: 5127/2009
DEPA R T MENT ACCOUNT PO NUMB INVOICE NUM BER AMOUN DESCRIPTION
1047 4350100 2905042 890.00 BUILDING REPAIRS MA
SANTAROSSA TILE CO., INC. I NVOICE
TILE TERRAZZO— MARBLE PRECAST TERRAZZO— CARPET —VINYL TILE
PHONE: (317) 632 -9494 FAX (317) 631 -5567
www.santarossa.com 5-11-09 15 7 2905042
REMIT TO: SANTAROSSA MOSAIC TILE CO., INC.
P.O. Box 664043
Indianapolis, IN. 46266 -4043 20458 2 9 0 5 0 4 2
CITY OF CARMEL 1 9300
9221
ONE CIVIC SQUARE
CARMEL, IN 46032
TERMS: NET 30 DAYS
RE: PO# 20458
1
JOB COMPLETE FOR THE SUM OF: 890.00
Purchase Tj t IK
Desc 1 „y� i�,� �Fl. o ®II9 IPP 1 C` !t f C•
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Unel esa
Purchaser Date 2 17
Approval date
PLEASE PAY THIS AMOUNT: 890.00
Late payments will be subject to late charges of 1 interest per month and reasonable attorney fees for Santarossa should the matter be placed with an attorney for collection.
DIRECT ALL NON PAYMENT CORRESPONDENCE TO: SANTAROSSA MOSAIC TILE CO, INC. P.O. BOX 18181 INDIANAPOLIS, IN 46218
1 ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Santarossa Mosaic Tile Co., Inc. Terms
P.O. Box 664043
Indianapolis, IN 46266 -4043
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
5111109 2905042 Tile in MC locker rooms 20458 890.00
Total 890.00
1 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.
Santarossa Mosaic Tile Co., Inc. Allowed 20
P.O. Box 664043
Indianapolis, IN 46266 -4043
In Sum of
890.00
ON ACCOUNT OF APPROPRIATION FOR
104 Program Fund
PO# or INVOICE N0. A.CCT #/TITLE AMOUNT Board Members
Dept
1047 2905042 4350100 890.0,0 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
21 -May 2009
Signature
Is 890.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund