331826 10/30/18 CITY OF CARMEL, INDIANA VENDOR: 281260
ONE CIVIC SQUARE SEWER EQUIP CO OF AMERICA CHECK AMOUNT: $*****2,051.75*
CARMEL, INDIANA 46032 1590 DUTCH
ROAD CHECK NUMBER: 331826
DIXON
a„*oN�• CHECK DATE: 10/30/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 0000168295 2,051.75 OTHER EXPENSES
VOUCHER NO. 186747 WARRANT NO. ALLOWED 20 Prescribed by State Board of Accounts City Form No.201(Rev 1995)
Vendor # 281260 IN SUM OF$ ACCOUNTS PAYABLE VOUCHER
SEWER EQUIP CO OF AMERICA CITY OF CARMEL
1590 DUTCH ROAD An invoice or bill to be properly itemized must show: kind of service,where performed,
DIXON, IL 61021 dates service rendered, by whom, rates per day, number of hours, rate per hour,
numbers of units, price per unit, etc.
Payee
$2,051.75 281260 Purchase Order No.
ON ACCOUNT OF APPROPRATION FOR SEWER EQUIP CO of AMERICA Terms
Carmel Wasterwater Utility 1590 DUTCH ROAD Due Date
BOARD MEMBERS
I hereby certify that that attached invoice DIXON, IL 61021
(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
0000168295 01-7500-02 $2,051.75 and received except 10/25/2018 0000168295 $2,051.75
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
159.0`Dutch Road Invoice No 0000168295
Dixon_,IL 61021
Phone: 815, 835=5566
�. ) Customer 000565
LEJ
Bill to : SHIPPED TO ADDRESS:
CARMEL WASTEWATER TREATMENT
CARMEL, IN UTILITIES, CITY OF 9609 HAZEL DELL PARKWAY
WWTP&SEWER DEPT ATTN: DUANE JARVIS
9609 HAZEL DELL PARKWAY INDIANAPOLIS, IN, 46280
INDIANAPOLIS IN 46280 United States
United States
PHONE(317)571-2634 FAX(317)571-2629 Sales Order: 110662 Packing List: Y29214
Customer PO Number Invoice Date Terms FOB Shipping Point Ship Via Salesperson
S19009 10/18/18 NET 30 DAYS. SP UPS DM
Item Part/Rev I Description/Details Quantity Backorder Unit Price Extended Price
000010 23109-00-Z-KIT,PACKING,L1118&L1618 1.00 EA 0.00 $224.0000 $224.00
0.00
000020 21797-00-Z-NUT,PLUNGER,L11 3.00 EA 0.00 $27.0000 $81.00
0.00
000030 21798-00-Z-WASHER,L11 3.00 EA 0.00 $4.0000 $12.00
0.00
000040 21799-00-Z-CYLINDER,ASSY,2-1/4",L11 3.00 EA 0.00 $219.0000 $657.00
0.00
000050 21096-00-X-NUT,BRASS,L11 3.00 EA 0.00 $4.0000 $12.00
0.00
000060 21800-02-Z-CUP,PLUNGER,SS,L11 3.00 EA 0.00 $349.0000 $1,047.00
0.00
000070 SHIPPING-Shipping/Freight Charge,Ref Shipper No 1.00 0.00 $18.7500 $18.75
Y29214 Shipped on 10/17/2018
0.00
Remit To:
1590 Dutch Road
Dixon,IL 61021
Please contact Accounts Receivable at 815-835-5566 with any questions or concerns regarding your invoice.
**All balances past due are subject to a 11%per month late charge.**
Customer Copy
Invoice No 0000168295
Customer 000565
Bill to : SHIPPED TO ADDRESS:
CARMEL WASTE WATER TREATMENT
CARMEL, IN UTILITIES, CITY OF 9609 HAZEL DELL PARKWAY
WWTP&SEWER DEPT ATTN: DUANE JARVIS
9609 HAZEL DELL PARKWAY INDIANAPOLIS, IN, 46280
INDIANAPOLIS IN 46280
United States
Sales Order: Packing List:
Customer PO Number Invoice Date Terms FOB Shipping Point Ship Via Salesperson
S19009 10/18/18 NET 30 DAYS. NULL. NULL. DM
Item Part/Rev I Description/Details Quantity Backorder Unit Price Extended Price
----- --—--—--—-
----------------- - ------ ----------
Invoiced Backorder
Tracking No: Subtotal $2,033.00
1Z611OE20352155073 Shipping $18.75
Sales Tax $0.00
TOTAL INVOICE $2,051.75
Please pay balance due by Saturday November 17
2018.
Payable in US Dollars
Warranty tart date for manufactured equipment is the dat a the eqUiPME nt is shipped unless the equipment delivery to the end
user from the dealer will be delayed. The dealer must noti Sewer Equi ment Comp any of America in writing Nithin 30 days of
shipment. This delayed warranty start date is subject to al iproval in writi ig by Sewer quipment Company of America.
e have full service repair facilities for all wter pumps u ed on your etting equipment.
'on tact us for all your pump component ne s. Call 1-80 -323-1604, sk for Parts.
eceived by
ate: PO #: S j X09
se• P-45 d1orw C;., 011n ON
Remit To:
1590 Dutch Road
Dixon,IL 61021
Please contact Accounts Receivable at 815-835-5566 with any questions or concerns regarding your invoice.
**All balances past due are subject to a 1%per month late charge.**
Customer Copy
Shipping List Y29214
1590 Dutch Road Customer No 000565
Dixon,IL 61021
Phone:(815)835-5566 Sales Order Shipper
Ship to:CARMEL WASTE WATER TREATMENT PLANT Sold to: 9 A9 HAZEL DELEL L PKWY TREATMENT
9609 HAZEL DELL PARKWAY
ATTN: DUANE JARVIS INDIANAPOLIS IN 46820
INDIANAPOLIS IN 46280 United States
United States
Ship Date Customer PO #of Boxes Weight Ship VIA Bill of Lading F 0 B
1011712018 S19009 0 0.0000 UPS GROUND SP
Item Fac I Part I Rev 1 Description I Details Order Quantity Ship Quantity
000001 Default Sales Order 110662.00 Item 001
23109-00-Z Rev 000 UIM EA 1.0000
KIT,PACKING,L1118&L1618 1.0000
000002 Default Sales Order 110662.00 Item 002
2.1797-00-Z Rev 000 UIM EA 3.0000
NUT,PLUNGER,L11 3.0000
000003 Default Sales Order 110662.00 Item 003
21798-00-Z Rev 000 UIM EA 3.0000
WASHER,L11 3.0000
000004 Default Sales Order 110662.00 Item 004
21799-00-Z Rev 000 UIM EA 3.0000
CYLINDER,ASSY,2-114",L11 3.0000
000005 Default Sales Order 110662.00 item 005
J 21096-00-X Rev 000 UIM EA 3.0000
NUT,BRASS,1-11 3.0000-
000006 Default Sales Order 110662.00 Item 006.
21800-02-Z Rev 000 UIM EA 3.0000
CUP,PLUNGER,SS,L11 3.0000
Customer Copy Page 1 of 1