194952 03/02/2011 CITY OF CARMEL, INDIANA VENDOR: 354047 Page 1 of 1
ONE CIVIC SQUARE AQUA SYSTEMS CHECK AMOUNT: $77.00
CARMEL, INDIANA 46032 7785 EAST US HIGHWAY 36
AVON IN 46123 CHECK NUMBER: 194952
CHECK DATE: 3/2/2011
DEPARTMENT ACCOUNT P O NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1868049 77.00 MATERIALS SUPPLIES
A INVOICE
S1STFM5®
7785 East US Highway 36' Order No. Written By Order Date 6/11
Avon, IN 46123 Account 132504 EMOORMAN Wed. 02123111
800- 447 -5582 Technician Serv. Date
132506
www.ilovemywater.com Bill to Account Q No 0
CI� ���l S�� D ept Route Sequence
Name Last Del, SA2 01/11/11 11
Address 909 N Rangellne Ind
City Carmel IN 40032
Install Date Customer Installed
Phone 317 -571 -2845 1_
Hardness gpg Iron ppm ph
Ordered By
TDS ppm Watertype
Requested Time
No. of People
Comments:
(Alts. Qq. N o. Deschpon lax1h price t
12 t (.L W 5 Gallon Aqua S Bol Q 5. 30
92 Depash 5 g�lllon S elma U 0.00 y4�
_s..
0 RW RTN 5 9e1 SWe S IMIG! 4 0.00
4 cheduleld- Dellverles..
�u�orrrer is non-u
RENTAL WARRANTY
CHARGE RETURN
P e orn this will be mailed: HOURS RATE
Upo ceipt f merchandise or 7ices, customer agrees L A BOR
Next Delivery Date to pay in.full -b ue date. If pay is.not received, you are-
0212309 9 subject to colt tion fees e6'u ost and attorney fees, MATERIAL (TA�ABLE)�
Service /Delivery Tech. ue Date p /25/11 .r 1
Customer Name Please Print
I„
4..
Customer Signature
TAX
1 hereby acknowledge satisfactory completion of above described work. r'
30 Day Labor Warranty TOTAL tq'
VOUCHER 107219 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
1868049 01- 7200 -01 $77,00
Voucher Total $77.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995) 1
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
354047
AQUA SYSTEMS Purchase Order No.
7785 EAST US HIGHWAY 36 Terms
AVON, IN 46123 Due Date 2/24/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/24/2011 1868049 $77.00
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