227267 12/17/2013 CITY OF CARMEL, INDIANA VENDOR: 354047 Page 1 of 1
ONE CIVIC SQUARE AQUA SYSTEMS CHECK AMOUNT: $48.79
CARMEL, INDIANA 46032 7785 EAST US HIGHWAY 36
AVON IN 46123 CHECK NUMBER: 227267
CHECK DATE: 12/17/2013
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 2455670 48 . 79 MAT & SUPP-FIAZ MATERI
Q INVOICE
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SMEW
7785 East US Highway 36 Order No. 211 2q¢q 1'ia', Written By Af 1.. Order Date inn+
Avon, IN 46123 r
Account# 132504 ".; Technician F� r1n�htawt Serv. Date M2 to
800-447-5582 • ,;•. !��-�— - -�. ;FOB
www.ilovemywater.com Bill to Account# g6
Route No Sequence 0
Name C-Ny of Cpanal-Spw e r NO
Last•Del. 55-AS 07rr1143— 1
Address
City A RA22
Install Date Customer Installed
Phone#
Hardness gpg Iron ppm ph
Ordered By
TDS .ppm Watertype
Requested Time
No. of People
Comments:
i
A DeMeApean Tan Mee 7--Irl
V ---- S_ - 3-4�a1l�n �:�_ ems Batty_ -- -_..__ o _.._._._
...._..__ _5-m.._..
10.---_ �. DDS ._Deposit 5 gallon-
quo-Systems- - 0_
fl — RW RTN 5-gal Aqua Systems bottle o - 0.00
U Y
c heduled Deliveries. 12/05/13 Customer.ls'non-tax able
._......
._...... _._..._....
RENTAL WARRANTY
CHARGE RETURN
HOURS RATE
Next Delivery Date Me .....-
12/05/1
Service/Delivery Tech. -
Customer Name-Please Print
5.20
Customer Signature
I hereby acknowledge satisfactory completion of above described work i
30 Day Labor Warranty Due Date TOTAL
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.
I311M Custtomer. 13230 C o �� r 3•
GA en Vp to �91ays 31-60 Days : :Ayer 60 Days Balance Due
0.00 0.00 0.00 .0.00 0.00
VOUCHER # 137006 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
2455670 01-720H-08 $48.79
r
Voucher Total $48.79
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
354047
AQUA SYSTEMS Purchase Order No.
7785 EAST US HIGHWAY 36 Terms
AVON, IN 46123 Due Date 12/10/2013
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/10/201; 2455670 $48.79
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