250913 10/21/15 `� CITY OF CARMEL, INDIANA VENDOR: 366022
/ ONE CIVIC SQUARE XYLEM WATER SOLUTIONS CHECK AMOUNT: $*******559.50*
�? CARMEL, INDIANA 46032 26717 NETWORK PLACE CHECK NUMBER: 250913
�'��?on�°' CHICAGO IL 60673-1267 CHECK DATE: 10/21/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 3556861372 559.50 OTHER EXPENSES
Xylem'Water Solutions U.S.A., Inc.
7615 W. NEW YORK STREET
INDIA AP LI I 4 214
YOURPURCHASEORDER
N O S N 6
Tel. 317 273-4470 Fax: 317 273-4480 I V Q Y.. :.E.. - S15483
INVOICE NO. FUS NO. DATE SHIPPED DELIVERY NOTE
26717 Network Place 3556861372 A31986 9/25/15 C72607
Chita o, IL 60673-1267 INVOICE DATE TRN WHS PAYMENT TERMS
9 9/25/15 A3 1115 100 o N60 FROM INVOICE
.... . .. .............................._ 5.Sold To: o ............
Ship To:
Gtobal.No .........80.2.71;81
CARMEL UTILITIES WTP CARMEL WASTE WATER TREATMENT
9609 HAZEL DELL PKWY ATTN: Jeff Cooper
9609 HAZEL DELL PARKWAY
INDIANAPOLIS IN 46280
INDIANAPOLIS IN 46280
INCO TERMS DELIVERY TERMS ORDER PROCESSED BY
�_.__CA_`US_Wff/Factory__ _ :_ _._ _ _ PP/Add—Actual _sur-cha_ _ __FLYGT--INDIANAPOLIS,IN-BRA-----
SHIP VIA ORDER TEXT CUSTOMER TEXT
UPS-Next Day Air FLYGT PUMP PARTS Ed Ryan
........ ..
.............
` QUANTITY SHIPPED UNIT PRICE..
LINE ?>:»`>:'.:' fTEM/DESGRIPTIQIV :a>::»>:;':;? NET PRICE::;....'»»s>: ..EXTENDEDAMOUNT
.......... :::::.... UM a:: DISCOUNT CHARGE ...
Quote# 2015-IND-0549, ALTERNATE 1, VERSION 2
REPAIR PARTS FOR FLYGT PUMP PER SIN 085 . 182-0311928
(P/N 3085 . 182-4340)
001 0000003989804 1 18 . 00 18 . 000 18 . 00
CLAMP, CABLE (18) -20MM GR EN EA
002 0000006785822 1 9. 30 9 .300 9 .30
CLIP,CABLE PLASTIC NI EA
003 0000000824059 2 3 . 00 3 . 000 6 . 00
WASHER, SS 20 .5MM ID 35MM OD EA
004 0000000843534 1 17 . 00 17 . 000 17 . 00
GROMMET,CR 19ID 350D 22L EA
005 0000000942102 50 7 . 50 7 .500 375 . 00
CABLE, SUBCAB AWG 14/7 194M FT
SUE- 17OTAL OF POSITIONS 425 .30
*PLUS ACTUAL S & H CHA GES* 134 .20
Cont on 2
IMPORTANT-This invoice is governed by and subject to Xylem Rater Solutions USA,Inc.General Terms and Conditions of Sale. Different terms are hereby rejected unless expressly assented
to in writing. Terms are accessible at http://www.xylemwatersolutions.com/scs/usa/en-us/Pages/General-Terms-and-Condit ions-of-Sale.aspx
Xylem'Water Solutions U.S.A., Inc.
7615 W. NEW YORK STREET
INDIANAPOLIS,IN 46214 I V O I YOUR PURCHASE ORDER
Tel.(317)273-4470 Fax:(317)273-4480 S 15483
INVOICE NO. FUS NO. DATE SHIPPED I DELIVERY NOTE
26717 Network Place 3556861372 A31986 9/25/15 C72607
Chicago, IL 60673-1267 INVOICE DATE TRN WHS PAYMENT TERMS
9 9/25/15 A3 115 100% N60 FROM INVOICE
Page 2
Sold To: ;01..;6...34::.;;;;>;;;:; ;>:: ' Ship To:
Globa"I'N ............80.2.7.1.81..:..::.::....:'
CARMEL UTILITIES WTP CARMEL WASTE WATER TREATMENT
9609 HAZEL DELL PKWY ATTN: Jeff Cooper
9609 HAZEL DELL PARKWAY
INDIANAPOLIS IN 46280
INDIANAPOLIS IN 46280
)NCO TERMS DELIVERY TERMS ORDER PROCESSED BY
___ _CA.—__US_WH/Factory- -- - - ------ --—P-P-/-Add--Act-ual su-r-eha ----- FLYC-T--3NDIANAPOL-IS;IN BRA- - —
SHIP VIA ORDER TEXT CUSTOMER TEXT
UPS-Next Day Air FLYGT PUMP PARTS Ed Ryan
...................._....................._..........................................................................._..................-........................-......_........__............._...-. ..... .. .._.............__............-..-..-.....
_..................._.._............................................................................_..........._......._._............................................................-.............-......................................_....__.....
_................................................................__........................................................._......................._....................._..................._...................._..................................._......
_............................................._...................-._.............._....................._....-........................_........._.................................._..... _...........
_................................................................._............. .__........_.._-..................._.-..._... ................_ -......................................._.............._.............._..._.....-.....
QUANTITY SHIPPED UN T PR.b
NE ;>;::;:::;:::ITfM�DESCRIPTJOt� . NET PR10E EXTENDED AMOUNT
c»;>s;...... .... s>. s;::>.;. UM DISCOUNT CHARGE
..:.
NET MOUNT BEFORI TAXES USD 559 .50
DISPATCH INFO: 1Z4F398X0141150 88
O DER TOTAL USD
559 .50
IMPORTANT-This invoice is governed by and subject to Xylem Water Solutions USA,Inc.General Terms and Conditions of Sale. Different terms are hereby rejected unless expressly assented
Ito in writing. Teims are accessible at http://www.xylemwatersoIutions.com/scs/usa/en-us/Pages/General-Terms-and-Condit ions-of-Sale.aspx
1
VOUCHER # 156473 WARRANT # ; ALLOWED
352772
IN SUM OF $
Xylem Water Solutions USA Inc (GODW
+
26717 Network Place i!
Chicago, IL 60673-1267
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
I
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
3556861372 01-7200-04 $559.50
I ,I
i I
1
Voucher Total $559.50
i
Cost distribution ledger classification if
claim paid under vehicle highway fund
i'
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 10/13/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/13/201! 3556861372 $559.50
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