210740 07/17/2012 CITY OF CARMEL, INDIANA VENDOR: 354047 Page 1 of 1
0 ` ONE CIVIC SQUARE AQUA SYSTEMS CHECK AMOUNT: $42.29
CARMEL, INDIANA 46032 7785 EAST US HIGHWAY 36
AVON IN 46123 CHECK NUMBER: 210740
CHECK DATE: 7/17/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 2137128 42 . 29 OTHER EXPENSES
A Q INVOICE
I-2 i 37128 MHENDERSO 06120(12
7785 East US Highway 36 Order No. Written By Order Date
Avon, IN 46123 Account# o EMOORMAN Thu, 06/21/12
800-447-5582 132 Technician Serv. Date
www.ilovemywater.com Bill to Account# No 0
City of Carmel Sever Dept Route Sequence
Name 6AS 04/16/12 14
001 N Rangeline Rd Last Del.
Address
Carmel IN 40032
City Install Date Customer Installed
Phone# 317-571-2U5
Hardness gpg Iron ppm ph
Ordered By
TDS ppm Watertype
Requested Time
No. of People
Comments:
r,4
Exp.I t . Act+ . Ito, Description 'tax% price 'Total
10 i - S 5 Garton Aqua Systems Bottle- - - 5.50
10 c DDS D ®sit 5 gIaltorf Aqua Systems 0 0,00 4
0 r R5AS RTN 5 gal Aqua Systems bottle 0i 0.00
s,
Scheduled Deliveries: -00/21/12 - Customer is non-taxable -
__
........
RENTAL WARRANTY
CHARGE RETURN
0/ HOURS RATE TOTAL
® 21/12
Next Delivery Date � :•
MATERIAL
Service/Delive rY Tech
•
Customer Name-Please Print ,
5 120
Customer Signature
.......... /...._
I hereby acknowledge satisfactory completion of above described,work.
Due Date
........_.
30 Day Labor Warranty 07/26/12 (�
13111-16o Customer. 132303-City of Oamnsl sewer Dept
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
`;. 0.00 0.00 0.00 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 Due Date 7/6/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/6/2012 2137128 $42.29
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 Officer
VOUCHER # 125228 WARRANT # ALLOWED
354047 IN SUM OF $
AQUA SYSTEMS
7785 EAST US HIGHWAY 36
AVON, IN 46123
I
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
2137128 01-720H-08 $42.29
Voucher Total $42.29
Cost distribution ledger classification if
claim paid under vehicle highway fund