315300 08/29/2017 a C��MF
CITY OF CARMEL, INDIANA VENDOR: 00350779 CHECK AMOUNT: $*****1,047.35*
ONE CIVIC SQUARE B L ANDERSON CO. CHECK NUMBER: 315300
CARMEL, INDIANA 46032 4801 TAZER DRIVE
LAFAYETTE IN 47905 CHECK DATE: 08/29/17
�*1rtiN,io
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
OTHER EXPENSES
601 5023990 P7138 1,047.35
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Invoice B L Anderson Co.,Inc.
19 4801 Tuer Dr
41 Lafayette IN 47905
BL. ANDERSON 765-463-1518 phone
765-446-8390 fax
www.blanderson.com
Date Invoice#
8/3/2017 P-7138
Bill To Ship To
CARMEL WATER CARMEL WATER
3450 W. 131st St. 4915 E. 106th St.
Carmel,IN 46074 Indianapolis,IN 46280
Attn: John Mascari
P.O. Number Terms Rep Ship Date Project
JM072717 Net 30 RWL 7/28/2017
Quantity; Item Code Description Price Each Amount
2 Cla-Val 7194304H CRD IAS 30-300 TEBS 300S 311.00 622.00
3 Cla-Val9170003K KIT,RPPT CDHS18 TESR TE BR 83.00 249.00
4 Cla-Val 71885J SPR CRD TESTL 40.00 160.00
1 'Shipping and Handling Shipping and Handling 16.35 16.35
Overdue balance will
accrue interest at the rate of
1-1/2%per month
compounded plus legal and
collection fees.
Total $1,047.35
Packing Slip Report and Certificate of Conformance
7/27/2017 8:4:55 AM
From: From Warehouse: DALS Packing Slip: 196665
Cla-Val Co-Dallas Warehouse
8707 Forney Road
Dallas TX 75227
US
Marvin Lake
214-388-3493
Bill To: 2151 Ship To: (477)
BL ANDERSON CO INC CARMEL WATER
4801 TAZER DRIVE 4915 E. 106TH STREET
LAFAYETTE IN INDIANAPOLIS IN 46280
47905 US
US 317-716-6624
765-463-1518 EXT.224
Order Contact: Ship Early:
IIIIIIIIIIIIIIIIIIIIIIIIIHIIIIIIIII Ship Partial:
7/27/2017 204806 072717RL2 Prepaid and Charge BEST WAY STD 0.00 0
Packing Instructions: ATTN: JOHN MASCARI
TAG PO:JM072717
Line/Rel Item IN Qty Ordered Qty To Pack
1 7194304H EA 2.000 2.000
CRD 1/4S 30-300 TEBS 300S
2 9170003K EA 3.000 3.000
KIT,RPPT CRD/CDHS18 TESR
3 71885J EA 4.000 4.000
SPR CRD TESTL
Da t e �-�/-, 7
P
O # : —NO -717
ACCT # : `f
' Use :
DELIVERED AUG 14 2011
Certificate of Conformance/Compliance/Origin
This is to certify that the material shipped against your purchase order has been manufactured according to Cla-Val standards
and was inspected at our factory in Costa Mesa,California. The merchandise is of USA origin.
Neil Richey
Quality Assurance Ma ager ssrs v10 9/14/2015
CVC Griswold Industries mlake Page 1 of 1