171947 04/29/2009 CITY OF CARMEL, INDIANA VENDOR: 354037 1 1 Page 1 of 1
ONE CIVIC SQUARE MOST DEPENDABLE FOUNTAINS INC
CARMEL, INDIANA 46032 PO BOX 587 CHECK AMOUNT: $249.00
5705 COMMANDER DR
CHECK NUMBER: 171947
ARLINGTON TN 38002 -0587
CHECK DATE: 4/29/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1047 4237000 INV14492 104.00 REPAIR PARTS
'1125 4237000 INV14492 145.00 REPAIR PARTS
Al
r
NV
OM)F NUMBER INV14492
MOST DEPENDABLE 5705 Commander Dr. Arlington, Tn 38002 -0587
F OUNTAINS INC. (901) 867 -0039 (800) 552 -6331 Fax (901) 867 -4008 P.O. 2043
BILLED SHIPPED DATE
TO: TO:
CAR EL CLAY PARKS REC O II CARMEL CLAY PARKS REC
1411 EAST 116TH STREET
APR 1 6 1009 1427 EAST 116TH STREET
CARMEL IN 46032 CARMEL IN 46032
SHIP VIA UPS STANDARD
CUSTOMER CARMEL CLAY Order Date 4/13/2009
72 2 DESCRIPTION NET PRICE
3058 -2 -3 1/4" WHISTLE VALVE FOR JUG $50.00 $100.00
NLF -9 IN LINE VACCUM BREAKER $70.00 $140.00
GU.• 112.5- 4;- L) 3O -4a3� D 1tic p
uro 104 t d -3)D- �-�3^7
0
APR 1 2009
TERMS: NET 30 DAYS SUB TOTAL
$240.00
Please Pay from Invoice. No statement will be issued SHIP. HANDLING
FREIGHT F.O.B. FACTORY $9.00
ONE YEAR WARRANTY. LABOR NOT INCLUDED. TOTAL AMOUNT
$249.00
REMIT TO: P.O. BOX 587 5705 COMMANDER DR. ARLINGTON, TN 38002-0587
ORIGINAL WHITE OFFICE COPY YELLOW PACKING LIST PINK
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
354037 Most Dependable Fountains, Inc. Terms
P.O. Box 587
Arlington, TN 38002 -0587
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO Amount
4113109 INV14492 Repair parts for water fountain 20438 145.00
4113109 INV14492 Repair parts for water fountain 20438 104.00
Total 249.00
1 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
20
Clerk- Treasurer
Voucher No. Warrant No.
354037 Most Dependable Fountains, Inc. Allowed 20
P.O. Box 587
Arlington, TN 38002 -0587
In Sum of
e
249.00
ON ACCOUNT OF APPROPRIATION FOR
101 General Fund 104 Program Fund
PO# or INVOICE NO. ACCT #/TITLE AMOUNT Board Members
Dept
1125. INV14492 4237000 145.00 1 hereby certify that the attached invoice(s), or
1047 INV14492 4237000 104.00 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
22 -Apr 2009
Signature
249.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund