252174 12/02/1 5 CITY OF CARMEL, INDIANA VENDOR: 366022
' CHECK AMOUNT: $****22,799.83*
ONE CIVIC SQUARE XYLEM WATER SOLUTIONS
CARMEL, INDIANA 46032 26717 NETWORK PLACE CHECK NUMBER: 252174
CHICAGO IL 60673-1267 CHECK DATE: 12/02/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
652 5023990 3556869958 22,799.83 OTHER EXPENSES
Xylem- Water Solutions U .S.A. , Inc.
7615 W. NEW YORK STREET
INDIANAPOLIS,IN 46214 YOUR PURCHASE ORDER
Tel.(317)273-4470 Fax:(317)273-4480 N V`® � 515451
INVOICE NO. FUS NO. DATE SHIPPED DELIVERY NOTE
26717 Network Place 3556869958 A30208 11/18/15 C85261
Chicago, IL 60673-1267 INVOICE DATE TRN WHS PAYMENT TERMS
9 11/18/15 A3 088 100% N60 FROM INVOICE
Sold To: Custo.mer.No. 201654 Ship To:
Globaf No.' 8.027181
CARMEL UTILITIES WTP CARMEL WASTE WATER TREATMENT
9609 HAZEL DELL PKWY ATTN: DUANE JARVIS
9609 HAZEL DELL PARKWAY
INDIANAPOLIS IN 46280
INDIANAPOLIS IN 46280
FREIGHT TERMS DELIVERY TERMS ORDER PROCESSED BY
CA US WH/Factory PP/Add Order Positio FLYGT—INDIANAPOLIS,-IN
SHIP VIA ORDER TEXT CUSTOMER TEXT
Shipper choice-Ground FLYGT REPLACEMENT PUMP Ed Ryan
QUANTITY SHIPPED ::UNIT PRICE
/D
LINE ITEMESCRIPTION NET PRICE EXTENDED AMOUNT:.
UM DISCOUNT/CHARGE-
Quote# 2015-IND-0508
REPLACEMENT FOR EXISTING FLYGT PUMP IER SIN 3170 . 180-9340028
(P/N 3170 . 180-5102 )
001 0031711850348 1 22 , 382 . 000 22 , 382 . 00
NP435-6 30/460/3 50' FLS FV EA
S/N: 1570007 DIN 85261
ITEM NO. / SERVICE C DE: R01969
COST CENTER: DEPRECA ION
ACCOUNT CODE : 02 . 371 . 30
002 140000069983ON 1 417 . 830 417 . 83
SHIPPING AND HANDLING-NO TAX EA
ITEM NO. / SERVICE C DE: R01969
COST CENTER: DEPRECA ION
ACCOUNT CODE: 02 . 371 . 30
SUB- OTAL OF POS TIONS 22 , 799 . 83
*S & H CHARGED AS LINE ITEM*
TOTAL WEIGHT 818 . 00 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.xviemwatersolutions.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 YOUR PURCHASE ORDER
Tel.(317)273-4470 Fax:(317)273-4480 v'® I �' S15451
INVOICE NO. FUS NO. DATE SHIPPED I DELIVERY NOTE
26717 Network Place 3556869958 A30208 11/18/151 C85261
Chicago, IL 60673-1267 INVOICE DATE TRN WHS PAYMENT TERMS
9 11/18/15 A3 088 100% N60 FROM INVOICE
Sold To: Customer Ship To:
No. 201654 Page 2
Global.No. 8027181
CARMEL UTILITIES WTP CARMEL WASTE WATER TREATMENT
9609 HAZEL DELL PKWY ATTN: DUANE JARVIS
9609 HAZEL DELL PARKWAY
INDIANAPOLIS IN 46280
INDIANAPOLIS IN 46280
FREIGHT TERMS DELIVERY TERMS ORDER PROCESSED BY
CA —,-US-WH/Factory PP/Add Order Positio FLYGT—INDIANAPOLIS,IN BRA
SHIP VIA ORDER TEXT CUSTOMER TEXT
Shipper choice-Ground FLYGT REPLACEMENT PUMP Ed Ryan
QUANTITY SHIPPED UNIT PRICE
LINE ITEM/DESCRIPTION NET PRICE EXTENDED AMOUNT
UM -- DISCOUNT/CHARGE
NET kMOUNT BEFORI TAXES USD 22 , 799 . 83
11/18/15-US PORT expected exit date of 11/18/1S
TOT L WEIGHT ON D/N: C85261 ORDER TOTAL USD
DISPATCH INFO: 837416
22 , 799 . 83
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
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 11/24/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/24/201! 3556869958 $22,799.83
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 # 156748 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
i 3556869958 02-2308-00 $22,799.83
Depreciation
I
i
I
I
I Voucher Total $22,799.83
I
I
` Cost distribution ledger classification if
claim paid under vehicle highway fund