208195 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 354047 Page 1 of 1
ONE CIVIC SQUARE AQUA SYSTEMS CHECK AMOUNT: $82.29
CARMEL, INDIANA 46032 7785 EAST US HIGHWAY 36
AVON IN 46123 CHECK NUMBER: 208195
CHECK DATE: 4/2512012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 2098504 82.29 OTHER EXPENSES
A
A U INVOICE
S157EMS®
7785 East US Highway 36 Order No. 81-2018504 Written By RRBUTChiER Order Date 04112/12
Avon,IN 46123 I 132604
t Account Technician EMOORMAN Serv. Date
www.ilovemywater.com Mon. 04/16/1
800 447 -5582 13aS05
Bill to Account
Route No Sequence 0
Name City of Carmel Sewer Dept
Last Del. fiAS 02120112 12
Address 001 N Ranneline Rd
City Carmol IN 40032
Install Date Customer Installed
Phone �'�9- 3
Hardness gpg Iron ppm ph
Ordered By
TDS ppm Watertype
Requested Time
No. of People
Comments:
fit
i
i
Bx9. p Taftl
12 t 5 Gallon Aqua Systems Pottle o� X50
12 C VS Deposit 5 gallon Aqua Systems
0 W R TH 5 gal Aqua S ystems bottle
j
r
r
t
a
RENTAL WARRANTY
CHARGE RETURN
HOURS RATE
Next Delivery Date 04/16/12
MATE RIAL
Service /Delivery Tech. MATERIAL (NON-TAXABLE)
Customer Name Please Pri
Customer Signature
30 Da Labor Warrant e- desFribed
Y Y
FUEL SURCHARGE (TAXABLE)
I hereby acknowledge satistact 0. letion o Due TOTAL
Date 051WIl2
B&To Customer. 132303 My of Carmel Sewer Dept
A Q UA 44
Please pay from this bill. No other billing will be mailed. Upon receipt of merchandise or services, customer agrees to pay in full by
due date. If payment is not received, you are subject to collection fees, court costs and attorney fees.
Below is your account balance and aging as of the order date above. This balance does not reflect today's service or delivery.
Your prompt payment would be greatly appreciated.
Current. Up to 30 Days 31 -60 Days Over 60 Days Balance Due
0 .ao-; 0.00 D.oO 0.00 0.00
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
354047
AQUA SYSTEMS Purchase Order No.
7785 EAST US HIGHWAY 36 Terms
AVON, IN 46123 I Due Date 4/20/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/20/2012 2098504 $82.29
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 O er
VOUCHER 117201 WARRANT ALLOWED
354047 IN SUM OF
AQUA SYSTEMS
7785 EAST US HIGHWAY 36
AVON, IN 46123
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
2098504 01- 7200 -01 $41.14
2098504 01- 720H -08 $41.15
Voucher Total $82.29
Cost distribution ledger classification if
claim paid under vehicle highway fund