246191 06/17/15 (9,
CITY OF CARMEL, INDIANA VENDOR: 00350428 CHECK AMOUNT: $********60.29ONE CIVIC SQUARE AQUA SYSTEMS
CARMEL, INDIANA 46032 7785 E HIGHWAY 36 CHECK NUMBER: 246191
AVON IN 46168 CHECK DATE: 06/17/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 2793003 60.29 OTHER EXPENSES
A ' A INVOICE
S1STEA&® _,,,
�.1�.trN0LD 05127/1 S�
The Home Water ExpertsTM Order No. Written By Order Date
7 vbt� „::. S er+ sae. rr•�nrar
7785 East US Highway 36 Account# L{�r O0R`wIr�N i hu. 0"40/
Avon, IN 46123 l_,�1U ,.,:: - Technician Serv. Date
www.ilovemywater.com Bill to Account# No 0
Citta of Carmel HH1JV Dept. Route Sequence
NameSAS 09/H/12 10
901"N Ranaeline Rd. 'Last Del.
Address
Carmel IN 46032City Install Date Customer Installed
31 7571-264-5
Phone# Hardness gpg Iron ppm ph
Ordered By
TDS ppm Watertype
Requested Time
No. of People
Comments:N9F OPEN ON MONDAYS-TUESTHRU SAT-IF NOT.TI-ORE CAN
LEAVEAT Cllr Or CARMEL SEWER DEPT-SAME AMIRE55
-P_uQ,i Ac;._Qty- No- Gescription TaA €'rice Total
11-1 ` SAS 5 Gallon Aqua Systems Bottle 0 S.Sb <
L?5AS Iepcasit 5 gallon Aqua Sys IerrL 0 610-0
b 51 _ ftT l•1 5 gal f�glja Systems bottle 0 0.00
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RENTAL WARRANTY
Please pay from this bill.-No
CHARGE RETURN
t?5/y8r'15 r HOURS RATE
other billing will be mailed. Upon •
Next Delivery Date •:•
receipt of merchandise or
services, customer agrees to
pay in full by due date: If- �,
Service/Delivery Tech. payment is not received,you are • •= jy
Customer Name Please Print
subject to collection fees, court
•.
costs and attorney fees. S.29
Customer Signature -
r.
I hereby acknowledge satisfactory completion of above described work. '
30 Day Labor Warranty Due Date t7 25iI S • 11 �' . , 4
----------- ----------------------- ------ --- -------
For all your service and delivery needs, please contact the location nearest to.you.
Avon,IN Fishers,IN Greenwood,IN Fort Wayne,IN Lafayette,IN Muncie,IN Richmond,IN
(317) 272-3000 (317) 594-0644 (317) 889-6829 (260) 483-3963 (765) 447-3397 (765) 281-8820 (765) 935-5450
Saint Louis, MO Canal Winchester, OH Columbu6,.OH
(314) 832-5500 (614) 833-2800 (614) 265-9000
Below is your account balance and aging as of the order date above. This balance does not reflect today's service or delivery.
Your prompt payment would be greatly appreciatedJk�ti._. ;
For your convenience, you may now pay your bill online at tlWVemywater.com
Bili-Tr Custu,-ner: 132505-City of Cain d SE.}rer Dept
Current Up to 30 Days 31-60 Days Over 60 Days `B'alance Due
As of order date: a '�
VOUCHER # 155629 WARRANT# ALLOWED
354047 IN SUM OF $
AQUA SYSTEMS
7785 EAST US HIGHWAY 36
AVON, IN 46123
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
2793003 01-720H-08 $60.29
Voucher Total $60.29
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
354047
AQUA SYSTEMS Purchase Order No.
7785 EAST US HIGHWAY 36 Terms
AVON, IN 46123 Due Date 6/9/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/9/2015 2793003 $60.29
i
I
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.
Date Officer