217317 02/13/2013 CITY OF CARMEL, INDIANA VENDOR: 00350064 Page 1 of 1
j !. ONE CIVIC SQUARE POLLARD UNDERGROUND UTIL PROD CHECK AMOUNT: $189.33
�`. CARMEL, INDIANA 46032 200 ATLANTIC AVE
NEW HYDE PARK NY 11040 CHECK NUMBER: 217317
CHECK DATE: 2/13/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 I344074 189. 33 OTHER EXPENSES
r Remit to: Pollardwater.com -200 Atlantic Ave, New Hvde Park, NY 11040
West Coast - 17515 NE 67th Ct., Redmond, WA 98052
--- (800)437-1146
Invoice Invoice Number: 1344074-IN
Invoice Date: 1/23/2013
Order Number: S336414
Order Date 1/2212013
Customer Number: A13595
Sold To: Ship To:
Carmel Water Company Carmel Water Company
3450 West 131 st Street 3450 West 131 st Street
Carmel, IN 46032 Carmel, IN 46032
Confirm To:
Mike Luper
Customer P.O. Ship VIA F.O.B. Terms
verbal IBEST WAY Net 30 Days - No cash discount
Item Number Description UOM Ord Shp Bck Price Amount
P52617PIRANHA Piranha Blade Kit for Valve Box Cleaner EA 2 2 0 55.50 111.00
P52617MUD Mud Blade Kit for Valve Box Cleaner EA 1 1 0 55.50 55.50
P52613 #13 Pin EA 3 3 0 1.40 4.20
P52616 #16 Cotter Pin EA 3 3 0 0.05 0.15
Direct Entry
Thank you for the order and the opportunity to assist you - Kevin Twomey
For your future needs, you may reach me at either kevint @pollardwater.com or 800.437.1146 Ext. 202
Ship VIA BEST WAY Net Invoice: 170.85
Tracking # : 041462015139422; Less Discount: 0.00
Freight: 18.48
Sales Tax: 0.00
Invoice Total: 189.33
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
350064
POLLARD WATER Purchase Order No.
200 ATLANTIC AVE Terms
NEW HYDE PARK, NY 11040 Due Date 2/5/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
2/5/2013 1344074 $189.33
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
"z
Date Officer
VOUCHER # 123483 WARRANT # ALLOWED
350064 IN SUM OF $
POLLARD WATER
200 ATLANTIC AVE
NEW HYDE PARK, NY 11040
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
1344074 01-6200-06 $189.33
Voucher Total $189.33
Cost distribution ledger classification if
claim paid under vehicle highway fund