209267 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 354037 Page 1 of 1
ONE CIVIC SQUARE MOST DEPENDABLE FOUNTAINS INC CHECK AMOUNT: $66.00
CARMEL, INDIANA 46032 PO BOX 587
5705 COMMANDER DR CHECK NUMBER: 209267
ARLINGTON TN 38002 -0587
CHECK DATE: 5122/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4237000 INV25414 66.00 REPAIR PARTS
MUC E
OMDF
NUMBER INV25414
MOST DEPENDABLE 5705 Commander Dr. -Arlington, Tn 38002 -0587
IP O U N TA I N W INC. (901) 867 -0039 (800) 552 -6331 Fax (901) 867 -4008 PO. M0 0 0 717
DATE S�
BILLED F BY: SH IPPED
TO: TO:
CARMEL CLAY PARKS REC 0 2012 CARMEL CLAY PARKS REC
1411 EAST 116TH STREET I 1427 EAST 116TH STREET
CARMEL IN 46032 CARMEL IN 46032
SHIP VIA UPS GROUND
CUSTOMER C-ARM&L- GLA- Y Order Date 5/ 7-/ -2 "012—
e
1 ILS IN LINE STRAINER 1/4" SS $56.00 $56.00
Purchase -T
Description lQ�re�v�t av I na-vkia
P.O. {M o 1 7
G.L.
B;idt�t
L.ine Dnscr
Purchaser Date
Approval Data
TERMS: NET 30 DAYS SUBTOTAL $56.00
Please Pay from Invoice. No statement will be issued SHIP. HANDLING
FREIGHT F.O.B. FACTORY $10.OD
ONE YEAR WARRANTY. LABOR NOT INCLUDED. TOTAL AMOUNT $66.00
REMIT,T o v b- :00
_._QPAGINAL_WHI.TE 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
5/7/12 INV25414 Backflow prevention N.Trailhead 66.00
Total 66.00
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
66.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO# or INVOICE NO. ACCT#TTITLE AMOUNT Board Members
Dept
1125 INV25414 4237000 66.00 1 hereby certify that the attached invoice(s), or
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
17 -May 2012
Signature
66.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund