236823 9 /10/2014 "p' CITY OF CARMEL, INDIANA VENDOR: 368286
;, ® `i' ONE CIVIC SQUARE EVOQUA WATER TECHNOLOGIES CHECK AMOUNT: $**`....207.00*
_. a° CARMEL, INDIANA 46032 PO BOX 360766 CHECK NUMBER: 236823
�"'�ir6N�. PITTSBURGH PA 15251 CHECK DATE: 09/10/14
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 901839448 207.00 OTHER EXPENSES
Ark evoQUA Invoice
WATER TECHNOLOGIES
Branch: 019 Billing No.: 901839448
Billing Date: 08/27/2014
Sales Order/Contract: 40183363 / 10
Service Order No.: 51003756
Service/Work Date:. 08/26/2014
Customer No.: 1041262
Bill-to: 1041262 Customer PO No.: S14202
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: Net 45 days
INDIANAPOLIS IN 46280 Sales Rep: DANIEL GUISER
Functional Location: 0192160654
Remit-to address: Ship-to address: 2160654
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 W5TDIMB10079FSP DIMB10079FS US 2 EA 90.00 180.00 0.00 180.00
SDI MIXBEDI .79CF FBGLS P
STD POT
ECCN: EAR99
000020 W3TSP4276 1 EA 21.00 21.00 0.00 21.00
FUEL/ENERGY Surcharge
ECCN: EAR99
000030 W3TSP4255 1 EA 6.00 6.00 0.00 6.00
CHEMICAL SURCHARGE;
SMALL SDI TANKS
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 contrary to US law is prohibited. These items are not to be used directly or indirectly in
prohibited nuclear chemical/biological or missile weapons activities.
Net Total 207.00 USD
Page 1. of 2
J eIV'OQUA Invoice
% WATER TECHNOLOGIES
Branch: 019 Billing No.: 901839448
Billing Date: 08/27/2014
Service/Work Date:. 08/26/2014
Shipping and Handling 0.00 USD
State Tax 0.000 % 0.00 USD
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 207.00 USD
To pay by credit card, please call 1-800-875-7873 ext. 7034
If paid after 10/12/2014, please pay 210.11 USD
Page 2 of 2
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 9/4/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/4/2014 901839448 $207.00
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
VOUCHER # 145468 WARRANT # ALLOWED
368286 IN SUM OF $
EVOQUA WATER TECHNOLOGIES
PO BOX 360766
PITTSBURGH, PA 15251-6766
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
`73` '/
901839448 01-7 -05 $207.00
Voucher Total $207.00
Cost distribution ledger classification if
claim paid under vehicle highway fund