248108 07/29/2015 ,CAA .
;f CITY OF CARMEL, INDIANA VENDOR: 366022
.j, ® i• ONE CIVIC SQUARE XYLEM WATER SOLUTIONS CHECK AMOUNT: S'"""1,050.00"
?� CARMEL, INDIANA 46032 26717 NETWORK PLACE CHECK NUMBER: 248108
+Mr._ CHICAGO IL 60673-1267 CHECK DATE: 07/29/15
t reH�°
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 3556832744 1,050.00 OTHER EXPENSES
Page 1 of 1
xylem
Let's Solve!Nater
Bill To: Ship To: Please include the invoice number on all
CITY OF CARMEL CITY OF CARMEL remittances and include remittance copy with
3450 W 131 ST ST 3450 W 131 ST ST postal payments.
CARMEL, IN 46074 CARMEL, IN 46074 Invoice
3556.8_32744
Remit To: Billing Date Shipping Date
Xylem Inc. 03/24/2015
26717 Network Place Purchase Order Number
CHICAGO, IL 60673-1267 S13878
Sales Order ;
3556-942681
Shipping Reference Ship Via
Customer Number_ ' -Customer Location
8022006 103973
;Terms DUe,Date Salesperson Customer Contact Contact Phone Contact Fax ;
NET 60 05!23/2015
Item.;. Description; : . ".4 Qua,nt—it y;ShippedTax.a _-'Y" U tPriceExterded:Amounf
Num
1� --:1400000699711 N#START UP CHARGE FLYG � - 1 No Y — 1,050.00. - -41,050.00
Tax Summary _
Tax Code" =";Ta,x. Inclusive.Tax Tax Rrecedence.- - Tax Ezferided Amount
„
No data exists.
Special Instructions �� , �b3 ps SubTotal 1,050.00
-N/A- Tax 0.00
-- Shipping 0.00
Total 1,050.00
Payments and 0.00
Credits
Financial Charges 0.00
Outstanding balance 1,050.00
as of 07/08/2015 in
USD
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
352772
Xylem Water Solutions USA Inc (GODWIN PUMF Purchase Order No.
26717 Network Place Terms
Chicago, IL 60673-1267 Due Date 7/28/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/28/2015 3556832744 $1,050.00
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 # 156003 WARRANT # ALLOWED
352772 IN SUM OF $
Xylem Water Solutions USA Inc (GODW
26717 Network Place
Chicago, IL 60673-1267
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
3556832744 01-7363-05 $1,050.00
Voucher Total $1,050.00
Cost distribution ledger classification if
claim paid under vehicle highway fund