HomeMy WebLinkAbout221774 07/02/2013 a CITY OF CARMEL, INDIANA VENDOR: 366022 Page 1 of 1
ONE CIVIC SQUARE XYLEM WATER SOLUTIONS USA INC CHECK AMOUNT: $2,844.00
CARMEL, INDIANA 46032 PO BOX 223724
PITTSBURGH PA 15251-2724 CHECK NUMBER: 221774
CHECK DATE: 712/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 07739636 2 , 844 . 00 OTHER EXPENSES
Xylem Water Solutions U .S.A., Inc.
7665 W. NEW YORK STREET
INDIANAPOLIS,IN 46214 YOUR PURCHASE ORDER
Tel.(317)273-4470 Fax:(317)273-4480 I N V.D I C E S13606
INVOICE NO. FUS NO. DATE S
P.O. BOX 223724 HIPPED DELIVERY NOTE
07739636 903417 6/06/13 A89425
Pittsburgh, PA 15251-2724 INVOICE DATE TRN WHS PAYMENT TERMS
6/06/13 A3 115 NET 60 DAYS
Sold To: Customer No. 103973 Ship To:
CITY OF CARMEL CARMEL WWTP
ATTN: LISA KEMPER ATTN: BLAINE MALLABER
76.0 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 Order Positio FLYGT-INDIANAPOLIS, IN BRA
SHIP VIA ORDER TEXT CUSTOMER TEXT
FedEx PKG Ground Business BLAINE MALLABER ED RYAN
QUANTITY SHIPPED UNIT PRICE
LINE::_ ITEM/DESCRIPTION NET PRICE EXTENDED AMOUNT
UM DISCOUNT/CHARGE
001 0000003873250 1 1, 668 . 00 1 , 668 . 000 1, 668 . 00
VOLUTE, SH 3 " UNDR GPH FV CI EA
ITEM NO. / SERVICE CODE NS1316
COST CENTER: PROJECT
ACCOUNT CODE : 01 . 7200 . 03
002 0000003193800 1 389 . 00 389 . 000 389 . 00
RING,WEAR STATIONARY STEEL/ BR EA
ITEM NO. / SERVICE CODE 17018
COST CENTER: LIFT STATI NS
ACCOUNT CODE : 728 . 00
003 0000003452502 2 343 . 00 343 . 000 686 . 00
RING,WEAR ROTATING 304 EA
ITEM NO. / SERVICE CODE 17004
COST CENTER: LIFT STATI NS
ACCOUNT CODE : 01 . 7200 . 04
004 140000069983ON 1 101 . 00 101 . 000 101 . 00
FREIGHT CHARGE-NO TAX EA
Cont on 2
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 IN ® ICE SI3606
INVOICE NO. FUS NO. DATE SHIPPED DELIVERY NOTE
07739636 903417 6/06/13 A89425
P.O. BOX 223724
• Pittsburgh, PA 15251-2724 INVOICE DATE TRN WHS PAYMENT TERMS
6/06/13 A3 115 NET 60 DAYS
Page 2
Sold To: Customer No. 103973 Ship To:
CITY OF CARMEL CARMEL WWTP
ATTN: LISA KEMPER ATTN: BLAINE MALLABER
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 Order Positio FLYGT-INDIANAPOLIS, IN BRA
SHIP VIA ORDER TEXT CUSTOMER TEXT
FedEx PKG Ground Business BLAINE MALLABER ED RYAN
QUANTITY SHIPPED UNIT PRICE
LINE ITEM/DESCRIPTION NET PRICE EXTENDED AMOUNT:
UM DISCOUNT/CHARGE
004 140000069983ON
SUB-TOTAL OF POSITIONS 2 , 844 . 00
*FREIGHT CHARGED AS LINE ITEM*
TOTAL WEIGHT 64 . 000 LBS
NET AMOUNT BEFORE TAXES USD 2 , 844 . 00
IS ATCH INFO: 759028740107734 ORDER TOTAL USD
2 , 844 . 00
I
h'1`h
Prescribed by State Board of Accounts
Form No.301-S(Rev.1997) ACCOUNTS PAYABLE VOUCHER
TO
ADDRESS
Invoice Date Invoice Number Item Amount
I
1
I 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
Mo. Day Yr. Signature Title
I hereby certify that the attached invoice(s), or bill(s), is (are)true and corr ct and I have audited same in accordance
with Ic 5-11-10-1.6.
Mo. Day Yr. f er Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
-- " ""PAL WASTEWATER UTILITY ACCT.
No.
I
1
1
I
Amount of Warrant $
x Month of Yr
Acct.
* VOUCHER RECORD No.
Fq*ai3��v
Collection System
Pumping
Treatment&Disposal
ca
Customer Accounts
Administrative&General
Reclaimed Water Treatment
Reclaimed Water Distribution
Total
Allowed
Board Members
::,...;,...:. Filed
Y p
BOYCE FORMS•SYSTEMS 1-800-382-8702 325