223267 08/13/2013 ° . CITY OF CARMEL, INDIANA VENDOR: 367211 Page 1 of 1
ONE CIVIC SQUARE WATER SOLUTIONS UNLIMITED INC CHECK AMOUNT: $5,025.25
CARMEL, INDIANA 46032 PO BOX 347
FRANKLIN IN 46131 CHECK NUMBER: 223267
CHECK DATE: 8/1312013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 33430 5, 025 . 25 OTHER EXPENSES
WATER
SOLUTIONS O H WO U C R
UNLIMITED
P. O. Box 347 Invoice Number: 33430
295 Industrial Drive Invoice Date: Jul 19, 2013
Franklin, IN 46131 Page: 1
Voice: (317)736-6868
Fax: (317) 736-4322
Bill To: Ship to:
CARMEL UTILITIES CARMEL UTILITIES
3450 W. 131ST STREET 4915 E. 106TH ST.
CARMEL, IN 46074 CARMEL, IN 46033
USA USA
Customer ID Customer PO Payment Terms
CARMEL— D.R.#_1.42132_ __ _Net 30_Day_s_
_ .
Sales Rep ID Shipping Method Ship Date `Due Date
DH DAVID HARVEY VENDOR DIRECT 8/18/13
Quantity Item Description Unit Price Amount
2,475.00 TRAMFLOC 725 TRAMFLOC 725 COAGULENT 1.83 4,529.25
SHIP DATE 6/17/13
Subtotal 4,52925
Sales Tax
Subtotal Invoice Amount 5,025.25
Check/Credit Memo No: Freight Amount 496.00
TOTAL 5,025.25
Please remit payment to: Please include your invoice number on your check.
Water Solutions Unlimited, Inc.
P.O. Box 347
Franklin, IN 46131
VOUCHER # 132408 WARRANT # ALLOWED
367211 IN SUM OF $
WATER SOLUTIONS UNLIMITED INC
PO BOX 347
FRANKLIN, IN 46131-0347
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
33430 01-6180-03 $5,025.25
Voucher Total $5,025.25
Cost distribution ledger classification if
claim paid under vehicle highway fund
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
367211
WATER SOLUTIONS UNLIMITED INC Purchase Order No.
PO BOX 347 Terms
FRANKLIN, IN 46131-0347 Due Date 8/8/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/8/2013 33430 $5,025.25
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