221316 06/18/2013 CITY OF CARMEL, INDIANA VENDOR: 366022 Page 1 of 1
ONE CIVIC SQUARE XYLEM DEWATERING SOLUTIONS INC CHECK AMOUNT: $936.00
CARMEL, INDIANA 46032 PO BOX 935152
ATLANTA GA 31193-5152 CHECK NUMBER: 221316
CHECK DATE: 6/18/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350100 7735743 936 . 00 BUILDING REPAIRS & MA
Xylem Water Solutions U.S.A., Inc.
7615 W. NEW YORK STREET
INDIANAPOLIS,IN 46214 'T�TF+1� YOUR PURCHASE ORDER
Tel.(317)273-4470 Fax:(317)273-4480
MAY 282013 INVOICE 29603
INVOICE NO. FUS NO. DATE SHIPPED DELIVERY NOTE
07735743 899863 5/09/13 1 A83876
P.O. BOX 223724 -
Pittsburgh, PA 15251-2724__ INVOICE DATE TRN WHS PAYMENT TERMS
5/09/13 F1 1 124 NET 30 DAYS
Sold To: Customer.No. 170,568 Ship To:
CARMEL-CLAY PARKS & REC CARMEL-CLAY PARKS & REC
ATTN: PAULA SCHLEMMER ATTN: PAULA SCHLEMMER
1235 CENTRAL PARK DRIVE E 1235 CENTRAL PARK DRIVE E
CAMEL IN 46032
CAMEL IN 46032
INCO TERMS DELIVERY TERMS ORDER PROCESSED BY
CA US WH/ Factory No Freight Charge FLYGT-INDIANAPOLIS,IN BRA
SHIP VIA - ORDER TEXT CUSTOMER TEXT
MOBILE SERVICE TECH TOTALCARE BRONZE 04/17/13 GRANT BELLER
QUANTITY SHIPPED _ UNIT PRICE .
LINE. ITEM/DESCRIPTION NET PRICE EXTENDED AMOUNT
UM - DISCOUNT/CHARGE
ONSITE SERVICE CONTRACT PERFORMED ON 04/17/2013
BY: JERRY CROHN
CARMEL WATER PARK: PL 7061/665 SIN: 51041088 , 51161078
001 1400000699759N 1
TOTALCARE PM BRONZE-NO TAX EA
002 1400000699973A 8
LABOR,MOBILE-ININ EA
TOT PRICE/GROUP 001 - 002 936 . 00
SUB-TOTAL OF POSITIONS 936 . 00
** ADD NO FREIGHT CHARGES **
NET AMOUNT BEFORE TAXES USD 936 . 00
Purchase
Description
P.O.# P r
G.L.# 5Dx��� ORDER OTAL USD
es:sdget r
Line Desc
Purc!iaser Date 9 3 6 . 0 0
Approval Date
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.
Xylem Water Solutions USA Inc. Terms
P.O. Box 223724
Pittsburgh, PA 15251-2724
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) PO# Amount
5/9/13 7735743 Pump service FlowRider opening 29603 $ 936.00
Total $ 936.00
1 hereby certify that the attached invoice(s), or bill(s)is(are)true and correct and I have audited same in accordance
f with IC 5-11-10-1.6
, 20
Clerk-Treasurer
Voucher No. Warrant No.
Xylem Water Solutions USA Inc. Allowed 20
P.O. Box 223724
Pittsburgh, PA 15251-2724
In Sum of$
$ 936.00
ON ACCOUNT OF APPROPRIATION FOR
109 - Monon Center
PO#or Board Members
INVOICE NO ACCT#/TITLE AMOUNT
Dept#
1094 7735743 4350100 $ 936.00 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
13-Jun 2013
Signature
$ 936.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund