320905 01/17/2018 t'1�u,G4F,yfj
CITY OF CARMEL, INDIANA VENDOR:, 356869
'i ONE CIVIC SQUARE SEEPEX INC CHECK AMOUNT: $*******555.94*
CARMEL, INDIANA 46032 PO BOX 951454 CHECK NUMBER: 320905
irtiN- CLEVELAND OH 44193 CHECK DATE: 01/17/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER.' AMOUNT DESCRIPTION
651 5023990 30595364 555.94 OTHER EXPENSES
VOUCHER NO. 177168 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995)
Vendor# 356869 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
SEEPEX INC CITY OF CARMEL
PO BOX 951454 An invoice or bill to be properly itemized must show: kind of service,where performed,
CLEVELAND, OH 44193 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit,etc.
Payee
555.94 356869 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR SEEPEX INC Terms
Carmel Wasterwater Utility PO BOX 951454 Due Date
BOARD MEMBERS
I hereby certify that that attached invoice CLEVELAND,OH 44193
(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
30595364 01-7202-06 $555.94 and received except 12/28/2017 30595364 $555.94
l
41,
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
SEEPEX.
ALL THINGS FLOW
SEEPEX
BILL T0:
Inc.
Carmel WWTP 511 Speedway Drive j
Enon, Ohio 45323
9609 Hazel Dell Parkway USA
INDIANAPOLIS IN 46280 Phone (937)864-7150
USA Fax (937)864-7157
www.seepex.com
sales@seepex.net =
Invoice
SHIP TO File Copy
Carmel WWTP Page 1( 2) i
9609 Hazel Dell Parkway No. 30595364
CARMEL IN 46280 Date 09/14/2017
USA Delivery Note No. 1567723 t
Delivery Date. 09/14/2017
Our Order No. 2274675 i
REMIT TO: Your P.O. No. S17635
SEEPEX Inc. dated 09/14/2017
P.O. Box 951454 Your Customer No. 204168
Cleveland, OH 44193
USA
Terms of delivery
FOB Shipping Point Enon.
Shipping terms:
UPS NxtD Air
Weight total(KG)
5.0
Tracking No. 1 X48W560163121728
Item Material Qty. Price p. unit Discount Total(USD)
10 RSPF006207000XXXXX . 1 EAC 144.78 144.78
splash ring 62/70 NBR
20 DSGP106007000ATOP6 1 EAC 23.94 23.94
casing gasket 60/70 PTFE e156x e190x 1mm
30 MANF006007000XXXXX 1 EAC 152.45 152.45
universal joint sleeve 60/70 NBR
40 HBDA5060070003V216 1 EAC 74.10 74.10
holding band 60/70 V216 152x3/4 AISI 304
-Material Certificates aceto DIN EN 10204 3.1
50 HBDA5060070003V213 1 EAC 31.19 31.19
holding band 60/70 V213 101x3/4 AISI 304
-Material Certificates acc.to DIN EN 10204 3.1 k
ii
60 BGFY800000000KCOXX EAC 33.46 33.46
seepex joint grease type 30321 cartridge �
3OOg 310ccm
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Invoice 30595364 i
09/14/2017
Page 2( 2)
Items total _ 459.92
Freight + insurance 46.02
Special charges 50.00
Expedite Fee (
Net value 555.94
Final amount (USD) 555.94 x
Terms of payment
within 30 days net
Please note: These commodities, technology, or software were exported from the United States in 4
accordance with the Export Administration Regulations. Diversion contrary to U.S. law prohibited.
This invoice is subject to SEEPEX Inc. Terms & Conditions of Sale and/or Repair (1-8-16), available
online at www.seepex.com.
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