330098 09/19/18 �ur C�q�
�/ ��. CITY OF CARMEL, INDIANA VENDOR: 354047
' . CHECK AMOUNT: $********71.30*
ONE CIVIC SQUARE AQUA SYSTEMS
CARMEL, INDIANA 46032 7785 EAST US HIGHWAY 36 CHECK NUMBER: 330098
M��TON�. AVON IN 46123 CHECK DATE: 09/19/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 PSI3681285 71.30 OTHER EXPENSES
VOUCHER NO. 186432 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995)
Vendor# 354047 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
AQUA SYSTEMS CITY OF CARMEL
7785 EAST US HIGHWAY 36 An invoice or bill to be properly itemized must show: kind of service,where performed,
AVON, IN 46123 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit, etc.
Payee
71.30 354047 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR AQUA SYSTEMS Terms
Carmel Wasterwater Utility 7785 EAST US HIGHWAY 36 Due Date
BOARD MEMBERS
I hereby certify that that attached invoice(s), AVON, IN 46123
or bill(s)is(are)true and correct and that
PO# ACCT# the materials or services itemized thereon for DATE INVOICE# Description
DEPT# INVOICE# Fund# AMOUNT which charge is made were ordered and DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT
PSI3681285 01-7361-1-08 $71.30 and received except 9/10/2018 PSI3681285 $71.30
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
AZi��U,
� INVOICE
SYSTEMS
7785 fast US Highway 36
Avon, IN 46123 Invoice-Number: PSI-3681285
PHONE:(317)272-3000 or(800)447-5582 Sales Order Number.
-" FAX:(317)272-5000
Invoice Date: 9/4/2018
Page: 1
Bill Ship
To:- City of Carmel Sewer Dept-Carmel Utilities To: City of Carmel HHW Dept.
—Lisa. Bill
—30 West Main St 901'N Rangeline Rd.
Ste 220 Carmel,IN 46032
Carmel,IN 46032 . USA
USA
Ship Via Customer ID 132505
Posted Date 9/4/2018 P.O.Number
Due Date 9/25/2018 P.O.Date 8/31/2018
Shipment Method FOB Shipping Point Ship Date 9/4/2018
SalesPerson Tom Line Service No. SI-3514538
Next Delivery Date
Item.No. Description. Unit " Quantity Unit Price Total Price
5AS 5 Gallon Aqua Systems:Bottle Each 12 5.50 66.00
.DSAS Deposit 5 gallon Aqua Systems Each 12 6.00 72.00 .
'R5AS RTN 5 gal Aqua Systems bottle Each =12 6.00 -72.00
CONFEE Convenience fee. Each 1 5.30 5:30
Amount Subject to Sales Tax 0.00. Subtotal: 71.30.
Amount Exempt from Sales Tax 71.30
Total Sales Tax: 0.00
Freight: 0.00
Total: 71.30
THANK YOU FOR YOUR BUSINESS