319508 12/12/17 1 u,Ggy�f
CITY OF CARMEL, INDIANA VENDOR: 363353
4 I ONE CIVIC SQUARE JWC ENVIRONMENTAL LLC CHECK AMOUNT: $*****1,905.74*
CARMEL, INDIANA 46032 PO BOX-848853 CHECK NUMBER: 319508
�.y. LOS ANGELES CA 90084-8853 CHECK DATE: 12/12/17
DEPARTMENT_ ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 89417 1,905.74 OTHER EXPENSES
VOUCHER NO. 176870 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995)
Vendor # 363353 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
JWC ENVIRONEMENTAL CITY OF CARMEL
PO BOX 848853 An invoice or bill to be properly itemized must show: kind of service,where performed,
LOS ANGELES, CA 90084-8853 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit, etc.
Payee
$1,905.74 363353 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR JWC ENVIRONEMENTAL Terms
Carmel Wasterwater Utility PO BOX 848853 Due Date
BOARD MEMBERS
I hereby certify that that attached invoice LOS ANGELES,CA 90084-8853
(s),
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT for which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
89417 01-7202-06 $1,905.74 and received except 11/28/2017 89417 $1,905.74
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
Cost distribution ledger classification if claim paid motor vehicle highway fund. 20
Clerk-Treasurer
Invoice No: 89417
Date: 11/20/2017
.. Environmental® Order No: S028466
,"ONO' Page No: 1
2850 S. Red Hill Ave., STE 125 F.O.B: Origin
Santa Ana, CA 92705
(949) 833-3888
.SoldTo Ship To
Carmel WasteWater Utilities Carmel Wastewater Utilities
Carmel Waste Water Treatment Plant Carmel Waste Water Treatment Plant
9609 Hazel Dell Parkway 9609 Hazel Dell Parkway
Indianapolis, IN 46280-2935 Indianapolis, IN 46280-2935
US US
TIN:45-2771126 DUNNS#61-059-2388
-,CUSTOMER ID _'- CUSTOMER PO :. ' PAYMENT TERMS FREIGHT TERMS
—601-3429- — - - - 517621- - - - - Net-30-Days -- - — —Freight:-Bilied------ --
SALES REP ID SHIPPING METHOD SHIP DATE INVOICE DUE DATE
026 UPS Ground 11/20/2017 12/20/2017
QUANTITY,';-:> 1,.T . UNIT EXTENDED
,
LI# I° ORD 1. SHP -13CK1 " PART 'DESCRIPTION X" PRICE PRICE
1 1 1 0 34741 GASKET, STACK NUT COVER $2.99 $2.99
2 1 1 0 34014-0003 GASKET, GEAR HOUSING $17.61 $17.61
3 2 2 0 34014-0002 GASKET, END HOUSING $12.14 $24.28
4 2 2 0 34014-0001 GASKET,-MAIN HOUSING $17.61 $35.22
5 2 2 0 34044 GASKET, INSPECTION PORT $4.87 $9.74
6 2 2 0 END HOUSING 30004T DI $779.78 $1,559.56
P/N 34077-DI/B
Paint Epoxy Green -
7 4 4 0 34034 DISC, COMPRESSION-ETD150 $53.34 $213.36
8 1 1 0 INSTRUCTIONS DETAIL FOR SHOP FLOOR $0.00 $0.00
END HOUSING
SUB TOTAL: $1,862.76
SALES TAX: $0.00
SHIPPING & HANDLING CHARGES: $42.98
TOTAL AMOUNT DUE: $1,905.74
PLEASE REFERENCE THIS INVOICE
NUMBER ON YOUR CHECK AND REMIT TO: JWC Environmental,LLC
P.O.Box 848853
Los Angeles,CA 90084-8853
IF PAYING BY ACH OR WIRE: ACH/WIRE INSTRUCTIONS
BANK NAME:WELLS FARGO
ADDRESS: IRVINE,CA.
ABA#: 121000248
ACCOUNT#:4123519118
ACCOUNT NAME: JWC Environmental,LLC