207284 03/13/2012 CITY OF CARMEL, INDIANA VENDOR: 366022 Page 1 of 1
ONE CIVIC SQUARE XYLEM WATER SOLUTIONS CHECK AMOUNT: $158.39
CARMEL, INDIANA 46032 Po Box 223724
PITTSBURGH PA 15251 CHECK NUMBER: 207284
CHECK DATE: 3113/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 07674454 158.39 MATERIALS SUPPLIES
Xylem Dater Solutions U.S.A., Inc.
14125 SOUTH BRIDGE CIRCLE
CHARLOTTE, NC 28273 YOUR PURCHASE ORDER
Tel.(704)716 -7600 Fax:(704)716 -7610 C S13014
INVOICE NO. FUS NO. DATE SHIPPED DELIVERY NOTE
07674454 831970 2/21/12 967153
P.O. BOX 223724
Pittsburgh, PA 15251 -2724 NVOICE DATE TRN WHS PAYMENT TERMS
y 2/21/12 A3 11 15 NET 30 DAYS
Sold To: Customer' No 1039;73 Snip To:
CITY OF CARMEL CITY.OF CARMEL INDIANA
ATTN: LISA KEMPER
760 THIRD AVE SW 9609 HAZEL DELL PARKWAY
INDIANAPOLIS IN 46280
CARMEL IN 46032
ORDER LEAD TIME F.O.B /FREIGHT ORDER PROCESSED BY
1 week or less ex WWW or port PP /Add Actual surcha WEDECO- CHARLOTTE,NC
SHIP VIA ORDER TEXT CUSTOMER TEXT
UPS- Ground JULIE
LINE STEM /DESCRIPTION NET PRICE: EXTENDED AMOUNT I:
QUANTITY SHIPPED UNIT PRICE
UM: ;:j.. DISCOUNT /CHARGE;
001 7600000036392 8 19.00 19.000 152.00
BRUSH,TAK, SS FOR NEW SENSOR EA
OLD NUMBER: 136392
SUB-TOTAL OF POSITIONS USD 152.00
*PLUS ACTUAL FREIGHT CHARGES* 6.39
TOTAL WEIGHT 1.000 LBS
NET AMOUNT BEFORE TAXES USD 158.39
DIS ATCH INFO: 1Z4F398X0342816754
ORDER TOTAL USD
158.39
VOUCHER 116908 WARRANT ALLOWED
352772 IN SUM OF
Xylem Water Solutions USA Inc (GODW
PO box 223724
Pittsburgh, PA 15251 -2724
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
07674454 01- 7202 -05 $158.39
Voucher Total $158.39
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 203 (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
352772
Xylem Water Solutions USA Inc (GODWIN PUMF Purchase Order No.
PO box 223724 Terms
Pittsburgh, PA 15251 -2724 Due Date 3/5/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/5/2012 07674454 $158.39
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
3.
Date Officer