211871 08/14/2012 CITY OF CARMEL, INDIANA VENDOR: 354037 Page 1 of 1
ONE CIVIC SQUARE MOST DEPENDABLE FOUNTAINS INC CHECK AMOUNT: $154.00
CARMEL, INDIANA 46032 PO BOX 587
�Ltior�-a 5705 COMMANDER DR CHECK NUMBER: 211871
ARLINGTON TN 38002-0587
CHECK DATE: 8/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4237000 INV26393 154 . 00 REPAIR PARTS
o� UE
nf 0
MDF NUMBER INV26393
MOST DEPENDABLE 5705 Commander Dr. Arlington,Tn 38002-0587
F O U N TA I N S,INC. (901)867-0039 (800) 552-6331 Fax(901) 867-4008 P.O.#
M000781
DATE 7— (7—17Z
BILLED SHIPPED
TO: TO:
CAR4EL CLAY PARKS & REC CARMEL CLAY PARKS & REC
1411 EAST 116TH STREET ATTN:COURTNEY
1427 EAST 116TH STREET
CARMEL IN 46032 CARMEL IN 46032
SHIP VIA UPS GROUND
CUSTOMER # -CARMEL CLAY Order Date 7/17/2012
DESCRIPTION
•
1
7W2 0-RING VALVE 0-RING SS VALVE BODY W/FIT $61.00 $61.00 0-RING ASSEMB 0-RING STEM ASSEMBLY FOR 0- $41.00 $82-00
JUL 9 2012
Purchass
Description 91 0 1/1
P.O.# CYI -18 I p or F
G.L.# 11A5- L4-( j- 42 3_ -70(pp
Sudo-t
LinNoscr
Purchaser_Date___,_
Approval Date
TERMS: NET 30 DAYS SUB TOTAL $143.00
Please Pay from Invoice. No statement will be issued. SHIP.&HANDLING
FREIGHT F.O.B. FACTORY $11.00
ONE YEAR WARRANTY. LABOR NOT INCLUDED. TOTAL AMOUNT $154.00
REM • P.O. :•X 587�5705,Q,OMMAND DR. • :ee e
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
7/17/12 INV26393 Inlow water fountain repairs $ 154.00
Total $ 154.00
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
120_
Clerk-Treasurer
Voucher No. Warrant No,
354037 Most Dependable Fountains, Inc. Allowed 20
P.O. Box 587
Arlington, TN 38002-0587
In Sum of$
$ 154.00
ON ACCOUNT OF APPROPRIATION FOR
101 - General Fund
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1125 INV26393 4237000 $ 154.00 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
9-Aug 2012
Signature
$ 154.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund