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��p\''"� CITY OF CARMEL, INDIANA VENDOR: 368286
'� ONE CIVIC SQUARE EVOQUA WATER TECHNOLOGIES CHECK AMOUNT: $"""""1,854,69"
�� �� CARMEL, INDIANA 46032 PO BOX 360766 CHECK NUMBER: 233730
�1%,�TON�.` PITTSBURGH PA 15251 CHECK DATE: 06/18/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 901721118 1,854.69 OTHER EXPENSES
3 6F -2
0 eVOQUA Invoice
WATER TECHNOLOGIES
Branch: 019 Billing No.: 901721118
Billing Date: 05/27/2014
Sales Order/Contract: 70851320
Service Order No.: 50944991
Service/Work Date:. 05/16/2014
Customer No.: 1041262
Bill-to: 1041262 Customer PO No.: S13977
CITY OF CARMEL Incoterms(part 1): FOB Free on board
WASTEWATER TREATMENT PLANT Incoterms(part 2): Free on board
9609 HAZEL DELL PKWY Payment Terms: within 30 days Due net
INDIANAPOLIS IN 46280 Sales Rep: DANIEL GUISER
Remit-to"address:- Ship-to address: 2-160654
Evoqua Water Technologies LLC CARMEL WASTE WATER. UTILITIES
P.O: BOX 360766, 9609 HAZEL DELL PKWY
PITTSBURGH PA 15251-6766 INDIANAPOLIS IN 46280
United States
Telephone# 1-800-466-7873
Line Item Material Old Part Origin Qty./UO Unit Price Total Price Tax Total
Description Number M Currency USD Currency USD Currency USD
000010 W2T169463 ZWDJ02249 US 2 EA 51.96 103.92 7.27 111.19
HOSE 3/4" F-QD X MPT
24" ASSY TANK
ECCN: EAR99
000020 W2T163161 PGSS10025 US 2 EA 44.24 88.48 6.19 94.67
GAUGE PRESSURE SS EXT
SS INT 0-100
ECCN: EAR99
000030 _W2T169461 ZWDJ02247 US 2 EA _ 66.33 132.66 9.29 141.9.5
HOSE 3/4" F-QD X F-QD
24"
-- ECCN: EAR99 —_-- —_ —_-- -- _ — -- -
000040 W2T161380 ZWDJO5441 US 2 EA 22.31 44.62 3.12 47.74
LIGHT BODY 3/4" FPT PVC
ECCN: EAR99
000050 W2T169457 ZWDJ02240 US 1 EA 13.45 13.45 0.94 14.39
COUPLER FEMALE QD X
MPT (NEW STYLE)
ECCN: EAR99
000060 W2T152075 ZWDJ05408 US 2 EA 106.67 213.34 14.93 228.27
LIGHT PURITY 5 RANGE
W/XFMR 10' COR
ECCN: EAR99
000070 W2T149194 FCWNF20S2 US 2 EA 87.54 175.08 12.26 187.34
CART 20" 0.2UM CDE F
ASYM POLYSUL N _
ECCN: EAR99 v
Page 1 of 2
(, eVOQUA Invoice
WATER TECHNOLOGIES
Branch: 019 Billing No.: 901721118
Billing Date: 05/27/2014
Service/Work Date:. 05/16/2014
Line Item Material Old Part Origin Qty./UO Unit Price Total Price Tax Total
Description Number M Currency USD Currency USD Currency USD
000080 W2T144434 US 1 EA 41.80 41.80 2.93 44.73
FLTR,HSNG;SINGLE;REINFO
RCED POLYPRO;F
ECCN: EAR99
000090 W2T169711 _ FCGCF1020, US 2 EA 10.67_ 21.34 1.49 _2.2.83_
CART 10" 20UM CODE F
CARBON GRANULA.
ECCN: EAR99
000100 W5TDIMB10079FSP DIMB10079FS US 3 EA 90.00 270.00 18.90 288.90
SDI MIXBEDI .79CF FBGLS P
STD POT
ECCN: EAR99
000110 W3TSP4148 1 EA 750.00 750.00 0.00 750.00
LABOR - SYSTEM
INSTALLATION
ECCN: EAR99
For domestic shipments the following applies:
These commodities are sold for domestic consumption. Any export of these commodities must be made in accordance with
applicable US laws.
For export shipments from the US the following applies:
These commodities, technology or software (items) were exported from the United States in accordance with the Export
- - -Administration-Regulations-Diversion-contrar-y-to-US-law-is--prohibited—T-hese items are-not to be used directly or indirectly-in _-
prohibited nuclear chemical/biological or missile weapons activities.
Net Total 1,854.69 USD
Shipping and Handling 0.00 USD
State Tax 7.000 % � 7-7
County Tax 0.000 % �� 0.00 USD
City Tax 0.000 % 0.00 USD
Dist/Other Tax 0.000 0.00 USD
Total Amount Including Tax 1,93 . �D
To pay by credit card, please call 1-800-875-7873 ext. 7034 i
If paid after 06/27/2014, please pay 1,960.99 USD l �J y i0c1
Page 2 of 2
VOUCHER # 138229 WARRANT# ALLOWED
368286 IN SUM OF $
EVOQUA WATER TECHNOLOGIES
PO BOX 360766
PITTSBURGH, PA 15251-6766
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
.I
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
901721118 01-7202-05 $1,854.69
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{
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0
Voucher Total $1,854.69
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
368286
EVOQUA WATER TECHNOLOGIES Purchase Order No.
PO BOX 360766 Terms
PITTSBURGH, PA 15251-6766 Due Date 6/12/2014
Invoice Invoice Description
Date - Number (or note attached invoice(s) or bill(s)) Amount
6/12/2014 901721118 $1,854.69
l
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 -
to A3 y
Date Officer