187216 07/07/2010 CA CITY OF CARMEL, INDIANA VENDOR: 354047 Page 1 of 1
0 ONE CIVIC SQUARE AQUA
EAST U S TEE AY 36 CHECK AMOUNT: $55.50
7
s,,7a CARMEL, INDIANA 46032 AVON IN 46123 CHECK NUMBER: 187216
CHECK DATE: 7/7/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1747583 55.50 OTHER EXPENSES
'i
A INVOICE
f SVSTM®
7785 East US Highway 36 Order No. St-1749583 Written By d'RAUGHB Order D O &S110
Avon, 'IN 46123 Account 132504
800- 447 -5582 Technician EMOORMAN Serv. Da BIM
www.iiovemywater.com Bill to Account 132S05
Route No Sequence 0
Name Cly Carmel Sorer Dept
Last De(A 06113H0 i8
Address 001 N Ra noallne Rd
Cit Carmel IN 40032
Install Date Customer Installed
Phone 317 -571 -2646
Hardness gpg Iron ppm ph
Ordered By
TDS ppm Watertype
Requested Time
No. of People
Comments: 3 r
Ex NO. escnp an Tax pric
12 &AS 5 Gall Aqua Sydams Battle 0 5.39
12 0 DSAS Caposh 5 gallon Aquia- ems o 11.00
Q RW RTM 5 gal Aqua Sy; lams bii;Ws, t 0.00
a
9�y
Scheduled Deliveries: 00/29/10
Fuel Surcharge 2.50
RENTAL WARRANTY
M911 CHARGE RETURN
Please pay from this bill. No other billing will be mailed. HOURS aaTE
Next Delivery Date Upon receipt of merchandise or services, customer agrees
to pay in full by due date. If payMM&ceived, you are
subject to collection fees, court cos and attomey fees.
Service /Delivery Tech. Due Date
SUB-T
Customer Name Please Pri t
Customer Signature
I hereby acknowledge atisfact ry completion of above described work.
TOTAL
30 Day Labor. Warranty
VCDUCHER 105758 WARRANT ALLOWED
354047 IN SUM OF
AQUA SYSTEMS
7785 EAST US HIGHWAY 36
AVON, IN 46123
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
1747583 01- 7200 -01 $55.50
Voucher Total $55.50
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 f
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
354047
AQUA SYSTEMS Purchase Order No.
7785 EAST US HIGHWAY 36 Terms
AVON, IN 46123 Due Date 7/1/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/1/2010 1747583 $55.50
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