185867 05/26/2010 CITY OF CARMEL, INDIANA VENDOR: 364098 Page 1 of 1
ONE CIVIC SQUARE MCLEAN COOLING TECHNOLOGY
CARMEL, INDIANA 46032 15017 COLLECTION CENTER DRIVE CHECK AMOUNT: $95.96
CHICAGO IL 60693
CHECK NUMBER: 185867
CHECK DATE: 5/2612010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 6505092 95.96 OTHER EXPENSES
M CL e a n Order Invoice
COOLI TECH NOLOGY
A Pentwr Technicof Product-i Brand
11611 BUSINESS PARK BLVD N Business 62001387
CHAMPLIN MN 55316 -4900 P.0 JEFF COOPER
UNITED STATES Mark JEFF COOPER
Phone: (763) 323 -8200 Contact: Kellie
Fax: (763) 576 -3200
Order 12519416 SO 04/30/10
Invoice 6505092 RI 05/03/10
Sold To: CARMEL WASTE WATER TREATMENT PLANT Ship To: CARMEL WASTEWATER TREATMENT PL
SUITE 110 9609 HAZEL DELL PKWY
760 3RD AVE SW INDIANAPOLIS IN 46280 -2935
CARMEL IN 46032 -2072 UNITED STATES
UNITED STATES
JEFF
3175712634
Lan 61.1 Part Numbs Cataag Ntim3ier Ship Ship S i7nt brace Amount T'
Number. �escrzP 4ty iJM Rate k f;USA? (U81)) X
Shipment 125194160001
Tracking 220279272262182
1.000 10- 1000 -32 6.00 EA 04/30/10 A 15.0000 90.0000 Y
FLTR,INLET AIR,7.45x24.19x.34
2.000 FREIGHT 1.00 EA A 5.9600 5.9600 3
FEDEX FGR
i
Ship From Points
Sub Total: 95.96
A Anoka, MN
Sales Tax: .00
Total Amount: 95.96
Payment Terms: NET 30 DAYS Remit To: PENTAIR TECHNICAL PRODUCTS
Freight Terms as Agreed 15017 COLLECTION CENTER DR
CHICAGO IL 60693 -1000
UNITED STATES
Page 1 Printed 05/03/10 20:08:05
¢VOUCHER 105425 WARRANT ALLOWED
364098 IN SUM OF
MCLEAN COOLING TECHNOLOGY
15017 COLLECTION CENTER DRIVE
CHICAGO, IL 60693
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
6505092 01- 7202 -06 $95.96
Voucher Total $95.96
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice or bill to be properly itemized must show, kind of service, where
performed, dates of service rendered, by whom, rates per day, number of units,
price per unit, etc.
Payee
364098
MCLEAN COOLING TECHNOLOGY Purchase Order No.
15017 COLLECTION CENTER DRIVE Terms
CHICAGO, IL 60693 Due Date 5/13/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount.
5/13/2010 6505092 $95.96
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
Date Officer