251789 11/18/15 %' CITY OF CARMEL, INDIANA VENDOR: 366022
® l • ONE CIVIC SQUARE XYLEM INC CHECK AMOUNT: $****17,500.00*
,. �� CARMEL, INDIANA 46032 26717 NETWORK PLACE CHECK NUMBER: 251789
+.y,�ioN�" CHICAGO IL 60673-1267 CHECK DATE: 11/18/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 3556866073 17,500.00 OTHER EXPENSES
Xylem' Water Solutions U.S.A., Inc.
7615 W. NEW YORK STREET
_ _. _
...................................................................................
INDIANAPOLIS IN 46214
YOUR PURCHASE ORDER
_ :.:::1. .D:. ..L�.:.�{..::::::::.....::. S15324
Tel. 317 273-4470 Fax: 317 273 4480
.....
INVOICE NO. FUS NO. DATE SHIPPED DELIVERY NOTE
3556866073 A21952 10/23/15 C79242
26717 Network Place
Chicago, IL 60673-1267 INVOICE DATE TRN WHS PAYMENT TERMS
9 10/23/15 A3 088 100% N60 FROM INVOICE
..........................................
_......._...................................................
...............................................................................
Sold To: .Ustomer. Z 0165:4 Ship To:
<:Global.No......::....8 02 71:8.1.:..:.::>.....:
CARMEL UTILITIES WTP CARMEL WASTE WATER TREATMENT
9609 HAZEL DELL PKWY ATTN: DUANE JARVIS
9609 HAZEL DELL PARKWAY
INDIANAPOLIS, IN 46280
INDIANAPOLIS IN 46280
INCO TERMS DELIVERY TERMS ORDER PROCESSED BY
_CA w Factory_ PP/Add Order Positio FLYGT-INDIANAPOLIS,IN BRA
SHIP VIA ORDER TEXT CUSTOMER TEXT
Shipper choice-Ground CARMEL EQ BASIN PUMPS Ed Ryan
QUANTITY S'HIPFED iINITPRIG.E
..
;:LINE- %'::. >,tTEM DESCRIPTJON::..... s. »>.`>i` NET PRJGE EXFENDP :AMOUN i
UJ1R:;»»;>'s>.>:>a::::.:..;>DISCOIINT CHARGE.::::::....'..>:::...:.`.:;;>::::.:..:.......:.
Quote# 2015-IND-0362
CARMEL EQ BASIN FLYGT 3127 REPLACEMENT PUMPS (2 OF 3) .
001 0031271850004 2 8, 489 . 00 8, 489 . 000 16, 978 . 00
NP421-6 10/460/3 50' FLS FV EA
S/N: 1560107 D/N C79242
S/N: 1560108 D/N C79242
ITEM N0. /SERVICE CODE: R01938
COST CENTER: LIFT STATIONS
ACCOUNT CODE: 02 . 230 . 00
002 140000069983ON 1 522 . 00 522 . 000 522 . 00
SHIPPING AND HANDLING-NO TAX EA
ITEM NO. /SERVICE CODE: R01936
COST CENTER: LIFT ST TIONS
ACCOUNT CODE: 02 .230 . 00
SUB- 17OTAL OF POSITIONS 17, 500 . 00
*S & H CHARGED AS LINE ITEM*
TOTAL WEIGHT 820 . 500 LBS
Cont on . 2
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
to in writing. Terms are accessible at http://www.xylemwatersolutions.com/scs/usa/en-us/Pages/General-Terms-and-Condit ions-of-Sale.aspx
11�1.ylern Water Solutions U.S.A., Inc.
X
7615 W. NEW YORK STREET
INDIANAPOLIS IN 46214 YOUR PURCHASE ORDER
e 7 273-4470 Fax: 317 273-4480
N.V.
;.;Q>: .; ;:..:::::....... ::..... S15324
T 1. 31
INVOICE NO. FUS NO. 1 DATE SHIPPED DELIVERY NOTE
26717 Network Place 3556866073 . A21952 10/23/15 C79242
Chicago, IL 60673-1267 INVOICE DATE TRN WHS PAYMENT TERMS
9 10/23/15 A3 088 100% N60 FROM INVOICE
Page 2
Sold To: Customer nto Z 0165;4 snip To:
GtoFaF;No > > 8:'0:2::7.1. .1.................
CARMEL UTILITIES WTP CARMEL WASTE WATER TREATMENT
9609 HAZEL DELL PKWY ATTN: DUANE JARVIS
9609 HAZEL DELL PARKWAY
INDIANAPOLIS, IN 46280
INDIANAPOLIS IN 4628.0
INCO TERMS DELIVERY TERMS ORDER PROCESSED BY
CA Factory PP/Add Order Positio FLYGT-INDIANAPOLIS,IN BRA
SHIP VIA ORDER TEXT CUSTOMER TEXT
Shipper choice-Ground CARMEL EQ BASIN PUMPS Ed Ryan
...
:::.
QiJRNTETY,SHIPPED.::::::::a;:;;:UNIT 9.RIGE.::: ;;;:.
>;::<»»>'s's>:>::>s>z:<. NET:PRLCE. ; >.;>:.. ..:EXTENDED:AMOUN.T..:`>s
LINE ... .. ITEM/DESCRIPTION.,, ..:........ ':. <>:;;»:<>:;:::::`: ..:.
UM D1SC UNT CHARGE ..
Q. .-1 .. - ;:;;;;;;:::::.:.:::::.
NET AMOUNT BEFOR TAXES USD 17, 500 . 00
10/23/15-US PORT expected exit date of 10/-, 3/15
TOT L WEIGHT ON D/N:C79242 0 DER TOTAL USD
DISPATCH INFO: 836740
17, 500 . 00
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
to in writing. Terms are accessible at http://www.xylemwatersolutions.com/sr-s/usa/en-us/Pages/General-Terms-and-Condit ions-of-Sale.dspx
VOUCHER # 156608 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
,I
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
3556866073 02-2308-00 $17,500.00
Depreciation
i
i
l
Voucher Total $17,500.00 ,I
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
352772
Xylem Water Solutions USA Inc(GODWIN PUMF Purchase Order No.
26717 Network Place Terms
Chicago, IL 60673-1267 Due Date 11/5/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/5/2015 3556866073 $17,500.00
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
»l/3l-r Ci rti
Date Officer