189240 08/31/2010 CITY OF CARMEL, INDIANA VENDOR: 354047 Page 1 of 1
ONE CIVIC SQUARE AQUA SYSTEMS
CARMEL, INDIANA 46032 7765 EAST US HIGHWAY 36 CHECK AMOUNT: $55.34
AVON IN 46123 CHECK NUMBER: 189240
CHECK DATE: 8131/2010
DEPARTMENT A CCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1770303 55.34 OTHER EXPENSES
U
INVOICE
7785 East US Highway'36 f Order No. SI 1771]31]3 Written By t7TRaLIjMHt~3]M Order Da th3mrim 1
Avon, IN 46123 Account i325(M
800- 447 -5582 Technician r OMAN Serv. Da of 0AIl mn
www.ilovemywater.com Bill to Account 0 32605
Route NO Sequence 0
Name CltV of Carmel Sewer Dept
Last De 6A S 1161 2ho In
Address 901 N Rangellne Rd
Y
City Caramel 4603!
Install Date Customer Installed
Phone 1�� -�tl$
Hardness gpg Iron ppm_ ph
Ordered By TDS ppm Watertype
Requested Time
No. of People
Comments:
Eup Ate. No. Des4rl on Talc Price Total
5 Gallon Aqua SyMems Baffle
1 5 'r I e� ISlit 5 gallon ruin OMS
1
RW Rte 5 g al Aqua SyMems baffle o 0.0l c
Sch aduled Deliveries:
Custorner It non -table
Fuel Surcharge (Taxable) 2.34
RENTAL WARRANTY
CHARGE RETURN
Please pay from this bill. No other billing will be mailed. HOURS I RATE
Next Delivery Date Upon receipt of merchandise or services, customer agrees
to pay in full by due date- if payment is not received, you are
subject to collection fees, court cost and attorney fees.
08/1 v1®
Service /Delivery Tech. Due DARMi
Customer Name Please Print
Customer Signature
I hereby acknowledge satisfactory completion of above described work.
30 Day Labor Warranty
VOUCHER 106072 WARRANT ALLOWED
3540 I
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
1770303 01- 7200 -01 $55.34
Voucher Total $55.34
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 0 i
r�
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 8/24/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/24/2010 1770303 $55.34
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