222306 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 354047 Page 1 of 1
ONE CIVIC SQUARE AQUA SYSTEMS
CARMEL, INDIANA 46032 7785 EAST US HIGHWAY 36 CHECK AMOUNT: $60.29
•? AVON IN 46123
„o o CHECK NUMBER: 222306
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 2365297 60 . 29 OTHER EXPENSES
A INVOICE
U
SYSTM®
7785 East US Highway 36 Order No. 51r'a °Q Written By MMMpI Ep,-.o Order:Date na,
Avon, IN 46123 Account# 130$ T7e L
800-447-5582 Technician EMOORMAN -erv. Date Thl�n9t+1,r+3
www.iloverTiywater.com Bill to Account# 1325015
Route Mn Sequence fl
Name C.Byof Carmel Selmer Dept
Last Del. SS ' 19
Address 901 N Rangefine Rd
of
City ' ! IN 48032
Install Date . Customer,installed' ,,
�_1'v:a,Y.L_••'
Phone# 3176712945 -::
Hardness." gpg Iron ppm ph -
Ordered By TDS ppm Watertype.
Requested Time
No. of People
Comments:
fy ,
-0h
DentIDV W- �ftm
90- .... MS v Gallon Aqua Systems Bottle 0 5.30
..
10 -,MS- Deposit 5 gallon Aqua Systems 0 - - . 0.00
R --------RTN 5-4-el que Systems bottle. — - - -- - ---- 0.00-- --
1
cheduled Dellverles: 07/11/13 Customer/19'66n-taxably
;a
----------- - rU ,,', -------------- RENTAL WARRANTY
i 7 y /
CHARGE RETURN
.. HOURS iRATE
il
Next Delivery_Dte 07/11/13 --.
Service/Delivery Tech.
/�J•
Customer Name-Please Print _`-
��J!! ` 3.29
Customer Signature
l hereby acknowledge satisfactory'comptetion of above described works
30 Day Labor Warranty Due Date 08051113
811M Customer. 1325589-City of Carmel Seuver Dept
ACI-
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
O.Oa a.00 ®.ao o.00 �.ao
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 7/23/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/23/2013 2365297 $60.29
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 # 135997 WARRANT # ALLOWED
354047 IN SUM OF $
AQUA SYSTEMS
7785 EAST US HIGHWAY 36
AVON, IN 46123
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
2365297 01-720H-08 $60.29
Voucher Total $60.29
Cost distribution ledger classification if
claim paid under vehicle highway fund