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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