209402 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 366022 Page 1 of 1
ONE CIVIC SQUARE XYLEM WATER SOLUTIONS
CARMEL, INDIANA 46032 PO BOX 223724 CHECK AMOUNT: $12,266.14
PITTSBURGH PA 15251 CHECK NUMBER: 209402
CHECK DATE: 5/2212012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
652 5023990 07682595 1,891.07 OTHER EXPENSES
652 5023990 07685213 5,234.07 OTHER EXPENSES
651 5023990 07685214 5,141.00 OTHER EXPENSES
Xylem Water Solutions U.S.A., Inc.
7615 W. NEW YORK STREET
1NDIANAPOLIS,IN 46214 T 1�T O T j� YOUR PURCHASE ORDER
Tel.(317)273 -4470 Fax:(317)273 -4480 111 i 1� S13016
INVOICE NO. FUS NO. DATE SHIPPED I DELIVERY NOTE
P.O. BOX 223724 07685214 832408 5/08/12 A06655
Pittsburgh, PA 15251 -2724 INVOICE DATE TRN WHS PAYMENT TERMS
5/08/12 A3 088 NET 60 DAYS
Sold To: Customer No. 1039 Ship 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
INCO TERMS DELIVERY TERMS ORDER PROCESSED BY
CA US WH /Factory PP /Add Actual surcha FLYGT- INDIANAPOLIS,IN BRA
SHIP VIA ORDER TEXT CUSTOMER TEXT
Shipper choice Ground GREG STARK
QUANTITY SHIPPED UNIT PRICE
LINE ITEMIDESCRIPTION NET PRICE EXTENDED AMOUNT i
UM DISCOUNT /CHARGE'
001 0000007084815 1 5,141.00 5,141.000 5,141.00
IMPELLER,N 510MM CI 3312 EA
SUB-TOTAL OF POSITIONS USD 5,141.00
*PLUS ACTUAL FREIGHT CHARGES*
NET AMOUNT BEFORE TAXES USD 5,141.00
ORDER TOTAL USD
5,141.00
Xylem Water Solutions U.S.A., Inc.
7615 W. NEW YORK STREET
INDIANAPOLIS,IN 46214 YOUR PURCHASE ORDER
Tel.(317)273 -4470 Fax:(317)273 -4480 I N; V Q S13016
INVOICE NO. FUS NO. DATE SHIPPED DELIVERY NOTE
P.O. BOX 223724 07682595 832408 4/19/12 A02681
Pittsburgh, PA 15251 -2724 INVOICE DATE TRN WHS PAYMENT TERMS
4/19/12 A3 088 NET 60 DAYS
Sold To: Customer No. 1039 13 Ship 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 T PP /Add Actual surcha FLYGT- INDIANAPOLIS,IN BRA
SHIN VIA ORDER TEXT CUSTOMER TEXT
Shipper choice Gro GREG STARK
QUANTITY SHIPPED UNIT PRICE
LINE ITEM /DESCRIPTION NET PRICE EXTENDED AMOUNT
UM DISCOUNT /CHARGE
001 0000006904601 1 1,798.00 1,798.000 1,798.00
RING,INSERT CI EA
SUB-TOTAL OF POSITIONS USD 1,798.00
SINGLE FREIGHT CHARGE/SHIPMENT 93.07
TOTAL WEIGHT 135.300 LBS
r
,f
NET AMOUNT BEFORE TAXES USD 1,891.07
ALL FREIGHT +WEIGHT FOR D /N:A02681
DISPATCH INFO: 819469 ORDER TOTAL USD
1,891.07
Xylem Water Solutions U.S.A., Inc.
7615 W. NEW YORK STREET
INDIANAPOLIS,IN 46214 I N' V o C YOUR PURCHASE ORDER
Tel.(317)273 -4470 Fax:(317)273 -4480 S13016
INVOICE NO. FUS NO. DATE SHIPPED DELIVERY NOTE
07685213 832408 5/08/12 A06557
P. O. BOX 223724 INVOICE DATE TRN WHS PAYMENT TERMS
Pittsburgh, PA 15251 -2724 5/08/12 A3 10 88 NET 60 DAYS
Sold To: Gustomec No. 103973 Ship 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
INCO TERMS DELIVERY TERMS ORDER PROCESSED BY
CA US WH /Factory PP /Add Actual surcha FLYGT- INDIANAPOLIS,IN BRA
SHIP VIA ORDER TEXT CUSTOMER TEXT
Shipper choice- Ground GREG STARK
QUANTITY SHIPPED UNIT PRICE
LINE ITEWDESCRIPTION NET PRICE: AMOUNT
UM DISCOUNT %CHARGE.'
001 0000007084815 1 1 5,141.00 5,141.000 5,141.00
IMPELLER,N 510MM CI 3312 EA
SUB-TOTAL OF POSITIONS USD 5,141.00
SINGLE FREIGHT CHARGE /SHI MENT 93.07
TOTAL WEIGHT 179.300 LBS
NET AMO NT BEFORE TAXES USD 5,234.07
ALL FREIGHT +WEIGHT FOR D/N:A06557
DIS ATCH INFO: 412153 ORDER TOTAL USD
5,234.07
VOUCHER 117365 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
07685213 02- 2308 =00 $5,234.07
Depreciation
07W 595
Voucher Total t$5 -24
Cost distribution ledger classification if
claim paid under vehicle highway fund
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
352772
Xylem Water Solutions USA Inc (GODWIN PUMF Purchase Order No.
PO box 223724 Terms
Pittsburgh, PA 15251 -2724 Due Date 5/18/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/18/2012 07685213 $5,234.07
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