222504 07/30/2013 CITY OF CARMEL, INDIANA VENDOR: 354037 Page 1 of 1
ONE CIVIC SQUARE MOST DEPENDABLE FOUNTAINS INC CHECK AMOUNT: $342.00
CARMEL, INDIANA 46032 PO BOX 587
5705 COMMANDER DR
CHECK NUMBER: 222504
ARLINGTON TN 38002-0587
CHECK DATE: 7/30/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1125 4238000 INV29891 342 . 00 SMALL TOOLS & MINOR E
MUCE �III11W 010 aI I I1 1�iop
Moll ��1��1�
El 1 NUMBER INV29891
MOST OEPENDABLE 5705 Commander Dr.-Arlington,Tin 38002-0587
F O U IVI TA I N W INC. (901)867-0039•(800) 552-6331 •Fax (901)867-4008 P.O.# 30036
DATE
BILLED 1'_e
SHIPPED
TO: JUL 15 2013 TO:
CARMEL CLAY PARKS & REC CARMEL CLAY PARKS & REC
1411 EAST 116TH STREET BY:— ` 1427 EAST 116TH STREET
CARMEL IN 46032 CARMEL IN 46032
SHIP VIA UPS GROUND
CUSTOMER t CARMEL CLAY_ _ Order Date 7/10/2013
3 O-RING ASSEMB O-RING STEM ASSEMBLY FOR O $49.00 $147.00
3 O-RING VALVE O-RING SS VALVE BODY W/FI $61.00 $183.00
Wo_ - '' -��'
30050 F x
SUB TOTAL $330_00
Please Pay from Invoice. No statement will be issued. SHIPPING
!'p 12.o0
FREIGHT F.O.B. FACTORY
ONE YEAR WARRANTY. LABOR NOT INCLUDED. TOTAL AMOUNT $342.00
• - • :• • o - e � • :01
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
7/10/13 INV29891 Inlow water fountain repairs 30036 f $ 342.00
Total $ 342.00
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
20_
Clerk-Treasurer
Voucher No. Warrant No.
354037 Most Dependable Fountains, Inc. Allowed 20
P.O. Box 587
Arlington, TN 38002-0587
In Sum of$
$ 342.00
ON ACCOUNT OF APPROPRIATION FOR
101 -General Fund
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1125 INV29891 4238000 $ 342.00 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
25-Jul 2013
Signature
$ 342.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund