213216 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 364992 Page 1 of 1
ONE CIVIC SQUARE UNITED STATES GEOLOGICAL SURVEYCHECK AMOUNT: $3,310.00
CARMEL, INDIANA 46032 PO BOX 71362
PHILADELPHIA PA 19176-1362 CHECK NUMBER: 213216
CHECK DATE: 9/2512012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 90104461 3 , 310 . 00 OTHER EXPENSES
DI-1040 UNITED STATES DEPARTMENT OF THE INTERIOR Pagel
DOWN PAYMENT(BILL) REQUEST
Make Remittance Payable To: United States Geological Survey Bill#: 90104461
Billing Contact: Tonj R. Clark, Budget Analyst Phone: (317) 600-2723 Date: 07/13/2012
Due Date: 09/11/2012
Remit Payment To: United States Geological Survey
P.O. Box 71362
Philadelphia, PA 19176-1362
Payer: CITY OF CARMEL, CARMEL UTILITIES
MR. JOHN DUFFY Additional forms of payment may be accepted. Please
760 THIRD AVENUE, SW email gdatta @usgs.gov or call 703-648-7605 for
CARMEL IN 46032 additional information.
To pay through Pay.gov go to https://www.pay.gov. Checks must be made payable to
U.S. Geological Survey. Please detach the top portion
or include bill number on all remittances.
Amount of Payment: $ 75 /0-0)
.....................................................................................................................................................................................
Date Description Qty Unit Price Amount
Cost Per
07/13/2012 Expenses incurred for an investifation of water 1 3,310.00 1 3,310.00
resources to measure grond-water levels in a
network of observaion wells in Carmel and maintain
a real-time-water level observaion well for the
period of January 1, 2012 to September 30, 2012
12EMNF0000023
0
Amount Due this Bill: 3,310.00
Accounting Classification:
Sales Order: 20514
Sales Office: GENF
Customer Number: 6000001344
TIN: 356000972
VOUCHER # 122212 WARRANT # ALLOWED
74580 IN SUM OF $
USGS - DEPT OF THE INTERIOR
vd-M
2781 6, A.
%q./, 7G
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
90104461 01-6360-03 $3,310.00
Voucher Total $3,310.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
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
74580
USGS - DEPT OF THE INTERIOR Purchase Order No.
Water Resources Division Terms
5957 Lakeside Blvd Due Date 9/18/2012
Indianapolis, IN 46278
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/18/2012 90104461 $3,310.00
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 Officer