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308638 02/28/17
?('4�p'f• . CITY OF CARMEL, INDIANA VENDOR: 371510 ONE CIVIC SQUARE PURE WATER PARTNERS CHECK AMOUNT: $********55.00* CARMEL, INDIANA 46032 DEPT CH 19648 CHECK NUMBER: 308638 49'Mi_ 'i. PALATINE IL 60055-9648 CHECK DATE: 02/28/17 �rori�°� DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 2200 4239099 112712 55.00 OTHER MISCELLANOUS VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 371510 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER PURE WATER PARTNERS IN SUM of$ CITY OF CARMEL DEPT CH 19648 An invoice or bill to be properly itemized must show:kind of service,where performed,dates service rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. PALATINE, IL 60055-9648 Payee $55.00 ON ACCOUNT OF APPROPRIATION FOR Purchase Order# Engineering Terms Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 112712 42-390.99 $55.00 1 hereby certify that the attached invoice(s),or 2/11/117 112712 Water system $55.00 2200 201 2200 201 bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Tuesday, February 21,2017 Jeremy Kashman Director 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 20 Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer �. a purewa#erpprtners- K 'Oi' i 985trDtorsliMldanitcad:Suites: "•• C-MMA IN-46032 www4fikeh'lacom' f S66}b i�YSSO i spang Full "t B: CoFrlp@'ily laMO. CA' 1 -hone#: �� Cofiry Afloiie§4`:' Egiilpment •' n Address: Ad r�sg; Clt , ' te, Clbyy Siete,zip Email: 7INl 'Email. 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Please remit payment to avoid late charges.This invoice does not include previously billed and unpaid amounts of $0.00. Also consider paying online and setting up autopay. Customer Service For equipment service or for new orders please call: 866-621-6910 Office H2O For online payment or account issues call Paydici: 855-729-3424 x1 or email support@paydici.com For billing inquiries Call: 866-630-1608 or EMAIL billingsupport@financial-svcs.com Tax ID Number (TIN): 46-3033694, BILLING PERIOD: 01/26/2017 to 02/25/2017 22oc5 ��-t��lgoSq Save a stamp. Pay Online. go to www.purewaterpartners.com/access Enter Activation Code: H8CE-B2MV-KPCG-7BQ8