155759 01/23/2008 CITY OF CARMEL, INDIANA VENDOR: 139300 Page 1 of 1
ONE CIVIC SQUARE HYDRASERVE INC CHECK AMOUNT: $3,845.00
CARMEL, INDIANA 46032 7615 WEST NEW YORK STREET
INDIANAPOLIS IN 46214 CHECK NUMBER: 155759
CHECK DATE: 1/23/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 S11015 12253801 3,845.00 REBUILD KIT
HTDRASERVE INC. 1 a 3 r
7615 WEST NEW YORK STREET
INDIANAPOLIS, INDIANA 46214 INVOICE NO. INVOICE DATE ORDER NO. PAGE NO
PHONE: (317) 273 -4470 012253801 1/07/08 0122538 1
FAX: (317) 273 -4480
03 01685- 0 01 CUSTOMER P.O. ORDER DATE
H CITY OF CARMEL 511015 1/07/08
H
1 9609 HAZELDEL'L PARKWAY
F TERMS TERR.ISLSMN
T INDIANAPOLIS IN 46280 NET 30 DAYS 120
Q PLEASE PAY FROM INVOICE, A SERVICE CHARGE OF 1 112% PER MONTH
(ANNUAL RATE 18% WILL BE ADDED TO DELINQUENT ACCOUNTS.
1 0301685 -000
CITY OF CARMEL
'760 3RD AVE souTHWES'T
T SUITE 110
CARMEL IN 46032
NO RETURNS WITHOUT AUTHORIZATION.
ITEM NUMBER/ DESCRIPTION. ORDER QTY. B/O QTY. SHIP QTY. PRICE U1M PRICE EXTENSION aaano o
sroci
SHIPPED FROM WHSE. INDY ON 1/07 REF10122533 -ql VIA PICK -UP
0000006018932 1 1 3845.00 E AC14 3845.00
REBUILD KIT 3201
TOTAL THIS ORDER 3845.00
PAYMENT INFORMATION .007o DISCOUNT)
NET PMT NET DUI: DATE GROSS AMT GROSS DUE DA'L'E
3845.00 2/06/08 3845'.00 2/06/08.
TOTA
$3845.00
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
139300
HYDRASERVE INC Purchase Order No.
7615 WEST NEW YORK STREET Terms
INDIANAPOLIS, IN. 46214 Due Date 1/9/2008
Invoice Invoice Description
.Date Number (or note attached invoice(s) or bill(s)) Amount
1/9/2008 12253801 $3,845.00
hereby certify that the attached invoice(s), or bill(s) is Fare) true and
:orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
•'VOUCHER 077102 WARRANT ALLOWED
139300 IN SUM OF
HYDRASERVEINC
/615 WEST NEW YORK STREET
INDIANAPOLIS, IN 46214
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
d�. 371o.3d
12253801 02- 2308 -00 $3,845.00
Depreciation
v
Voucher Total $3,845.00
Cost distribution ledger classification if
claim paid under vehicle highway fund