155340 01/10/2008 a"•�, CITY OF CARMEL, INDIANA VENDOR: 139300 Page 1 of 1
h �1. ONE CIVIC SQUARE HYDRASERVE INC
CARMEL INDIANA 46032 7615 WEST NEW YORK STREET CHECK AMOUNT: $508.59
INDIANAPOLIS IN 45214 CHECK NUMBER: 155340
CHECK DATE: 111012008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 12220101 508.59 OTHER EXPENSES
HYDRASERVE INC. a I�OaC
7615 WEST NEW YORK STREET
INDIANAPOLIS, INDIANA 46214 INVOICE NO. INVOICE DATE ORDER NO. PAGE NO.
PHONE: (317) 273 -4470
FAX: (317) 273 -4480 012220101 12/13/07 0122201 1
0301685 CUSTOMER P.O. ORDER DATE
H CITY OF CARMEL S �f 12/1
P '760 3RD AVE SOU'THWES'T
S UITE 110 TERMS TERRJSLSMN
O C A RMEL I 4 603 2 PLEN! E�PA4QOIVPIVVOP�E. A SERVICE CHARGE OF 1 112% PER WOH
(ANNUAL RATE 18 WILL BE ADDED TO DELINQUENT ACCOUNTS.
B
1 0301685 -000
L CITY OF CARMEL
760 3RD AVE SOUTHWEST
0 SUITE 110
CARMEL IN 46032
NO RETURNS WITHOUT AUTHORIZATION.
ITEM NUMBER DESCRIPTION ORDER QTY. BIO QTY. SHIP QTY. PRICE U!M PRICE EXTENSION PaoMO o
STOCK
SHIPPED FROM WHSE. INDY ON I M 3 REF -91 VIA UPS I
ORDERED ITEM EZ2200 f
1
NS0076549 1 1 2L16 EACH 2y8.00'
EZ2200 1 1/2" LIFT OUT CPLG i I
ORDERED 1TEM 108 -113
I I
NS0078550 1 1 .195. 00 EACH 195..0Q
108 -1 B BRASS SEALING PLATE
FREIGHT' IN 1 1 65,59 EACH 65.591
TOTAL THIS ORDER
PAYMENT INFORMATIbN .00% DISCOUNT)
NET PMT NET 'DUE DATE" GROSS AMT GROSS DUE DATE
508.59 1/12/08 508 1/12/08
r
i
TOTAL
$-508.59
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 12/29/2007
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/29/200 12220101 $508.59
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
VOUCHER 077013 WARRANT ALLOWED
X139300 IN SUM OF
..HYDRASERVE IN�
}?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
12220101 01- 7200 -04 $443.00
12220101 01- 7200 -04 $65.59
Voucher Total $508.59
CCost distribution ledger classification if
,claim paid under vehicle highway fund