HomeMy WebLinkAbout202090 09/27/2011 CITY OF CARMEL, INDIANA VENDOR: 356597 Page 1 of 1
ONE CIVIC SQUARE DEZURIK WATER CONTROLS CHECK AMOUNT: $21,292.00
i CARMEL, INDIANA 46032 NW 5520 PO BOX 1450
MINNEAPOLIS MN 55485 -5520 CHECK NUMBER: 202090
CHECK DATE: 9/27/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
609 5023990 57010032 21,292.00 1050.06
@DeZURIK 250 Riverside Ave N 320 259 -2000 p
Bartell MN 56377 USA 320 259 -2227 f
INVOICE
Customer/ Original/ Page 1
Date Ship Date Customer PO No. Agent Ref. No. Invoice No.
08 -29 -2011 08 -26 -2011 W09397 911300 RPI/57010032
SOLD TO 122163 SHIPPED TO
CARMEL UTILITIES CARMEL UTILITIES
760 3RD AVE SW C/O CARMEL WTP PLANT 1
CARMEL, IN 3450 WEST 131ST STREET
46032 CARMEL, IN
46074
DEL.TERMS: Prepaid and Allow TERMS: Net 30 Days
ORDER NO.: 611459 DUE DATE: 09 -28 -2011
Dez (Customer I Quantity) Part Number I Revision I Price (Unit I Amount
ItemlItem I
I I I I I I I
Reference A 759230
Reference B TAS Project Name VALVE ACTUATOR PROCUREMENT FOR WTP PLANT NO. 1
THIS IS A FINAL RELEASE OF HOLD
FOR APPROVAL ITEMS TO PRODUCTION
IF PRODUCTS LISTED BELOW REQUIRE MATERIAL SAFETY
DATA SHEETS IN ACCORDANCE WITH OSHA (1910.1200
(B) (5) IV, (C) THEY WILL ACCOMPANY PRODUCT
SHIPMENT.
4 4 1.00 9609684 21292.00 ea 21292.00
DeZURIK BAW, 12, F1, CI,NBRN-NBR,150B,DI- S1 *X *A22383
TAG: B-100A
Goods Total USD
21292.00 21292.00
PLEASE REFERENCE OUR INVOICE NO. RPI/57010032 WHEN REMITTING PAYMENT.
REMIT TO: DeZURIK, Inc. COURIER TO: DeZURIK, Inc. WIRE TO: DeZURIK, Inc.
NW 5520 Lockbox NW 5520,C/O Wells Fargo Lock Box Account Number 4121081996
PO BOX 1450 1350 Energy Lane, Suite 200 ABA #121000248 Wells Fargo Bank
Minneapolis, MN 55485 -5520 Saint Paul, MN -55108 San Francisco, CA
Form: 1685 -0109
VOUCHER 112410 WARRANT ALLOWED
356597 IN SUM OF
DeZURIK WATER CONTROLS
Iversi a venue o
a I l e at r Ut"I't
ON ACCOUNT OF AP ROPR AOR�
SS 7,r3
Board members
PO INV ACCT AMOUNT Audit Trail Code
57010032 99= 11050-96- $21,292.00
C' �t,►,y1�Gfl0
Voucher Total $21,292.00 l
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
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
356597
DeZURIK WATER CONTROLS Purchase Order No.
250 Riverside Avenue North Terms
Sartell, MN 56377 Due Date 9/13/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/13/2011 57010032 $21,292.00
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date ffi