202910 10/25/2011 CITY OF CARMEL, INDIANA VENDOR: 354047 Page 1 of 1
ONE CIVIC SQUARE AQUA SYSTEMS
CHECK AMOUNT: $86.24
CARMEL, INDIANA 46032 7785 EAST US HIGHWAY 36
AVON IN 46123 CHECK NUMBER: 202910
CHECK DATE: 10/25/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 1994260 86.24 OTHER EXPENSES
r
A UA INVOICE
7785 East US Highway 36 Order No. ''a+t t Written By
MRIOU Order Date
Avon, IN 46123
Account
800 447 -5582 T° ..t Technician �E OORN,AN Serv. Date lAlnwl �n�ncr�i
www.ilovemywater.com Bill to Account rang
Route IN,0 Sequence 8
Name a fty. R sr.� w)
Last Del. SAS am 7M,
Address 0 01 N Ran® ld
City e l im 3a�
~�1T4� Install Date Customer Installed
Phone
Hardness gpg Iron ppm ph
Ordered By
TDS ppm Watertype
Requested Time
No. of People
Comments:
ttp. Act. My. Flo. DescrdptIo n Tax °b Price Total
14 SAS 5 Gallon Aqua SyMems 0 5.50 O
14 DW Doposlt 5 gallon Aqua t ®ens 0 0.00
0 RSAS RTN 5 gal Aqua Symms bottle 0 0.00
cheduled Deliveries: 10/05/11 r Customer is non- tiocel�
RENTAL WARRANTY
CHARGE RETURN
Please pay from this bill. No other billing will be mailed. HOURS RATE TOTAL
Next Delivery Date 10/05/11 Upon receipt of merchandise or services, customer agrees LABOR
to pay in full by due date. If payment is not received, you are
subject to collection fees, court cost and attorney fees. MATERIAL (TAXABLE)
Service /Delivery Tech. Due late ��a�'11 MATERIAL (NON-TAXABLE)
�7_ D
Customer Name Please Print
V 3.74
Customer Signature
ti
TOTAL
I hereby acknowledge satisfactory completion of above described work.
ALLOWED Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
IN SUM OF 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
K:
354047
i
AQUA SYSTEMS Purchase Order No.
a 7785 EAST US HIGHWAY 36 Terms
AVON, IN 46123 Due Date 10/18/2011
Board members
Invoice Invoice Description
Audit Trail Code Date Number (or note attached invoice(s) or bill(s)) Amount
10/18/201' 1994260 $86.24
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 116024 WARRANT
354047
AQUA SYSTEMS
7785 EAST US HIGHWAY 36
AVON, IN 46123
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
PO INV ACCT AMOUNT
1994260 01- 7361 -08 $43.12
7V OJ
1994260 01- 7360 -01 $43.12
Voucher Total $86.24
Cost distribution ledger classification if
claim paid under vehicle highway fund