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Home My WebLink About251527 11/18/15 ,CA9 CITY OF CARMEL, INDIANA VENDOR: 368286 ® 'r ONE CIVIC SQUARE EVOQUA WATER TECHNOLOGIES CHECK AMOUNT: $*******426.00* +. CARMEL, INDIANA 46032 PO BOX 360766 CHECK NUMBER: 251527 PITTSBURGH PA 15251 CHECK DATE: 11/18/15 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 902382794 426.00 OTHER EXPENSES 0 evoQUA Invoice WATER TECHNOLOGIES Branch: 019 Billing No.: 902382794 Billing Date: 10/28/2015 Sales Order/Contract: 40216890 / 10 Service Order No.: 51335689 Service/Work Date% 10/27/2015 Customer No.: 1041262 Bill-to: 1041262 Customer PO No.: S15545 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 9,609 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 99.00 198.00 0.00 198.00 SDI MIXBEDI .79CF FBGLS P STD POT ECCN: EAR99 000020 W2T169711 FCGCF1020 US 2 EA 12.00 24.00 0.00 24.00 FILTER CTRDG,10" 20UM CODE F GAC ECCN: EAR99 000030 W2T149194 FCWNF20S2 US 2 EA 96.00 192.00 0.00 192.00 FILTER CTRDG,20" 0.2UM CDE F POLYSUL N ECCN: EAR99 - - _ HTS: 842-1990040 - 000040 W3TSP4276 1 EA 12.00 12.00 0.00 12.00 FUEL/ENERGY Surcharge ECCN: EAR99 Net Total 426.00 USD 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 426.00 USD To pay by credit card, please call 1-800-875-7873 ext. 7034 Page 1 of 2 eVOQUA Invoice WATER TECHNOLOGIES Branch: 019 Billing No.: 902382794 Billing Date: 10/28/2015 Service/Work Date:. 10/27/2015 If paid after 12/12/2015, please pay 432.39 USD Destination Control Statement: the above commodities, software or technology are being sold pursuant to United States Export i Regulations. Export, re-export or other diversion contrary to law s prohibited These items are not to be used directly or Indiirectly in prohibited nuclear, chemical/biological or missile weapons activities. 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 11/5/2015 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 11/5/2015 902382794 $426.00 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 # 156613 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 902382794 01-7202-05 $228.00 902382794 01-7362-05 $198.00 Voucher Total $426.00 Cost distribution ledger classification if claim paid under vehicle highway fund