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235778 08/13/14 CITY OF CARMEL, INDIANA VENDOR: 358403 ONE CIVIC SQUARE CHARDON LABORATORIES INC CHECK AMOUNT: $*****1,750.00* CARMEL, INDIANA 46032 ACCTS RECEIVABLE CHECK NUMBER: 235778 *rroa' 7300 TUSSING ROAD CHECK DATE: 08/13/14 REYNOLDSBURG OH 43068 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1208 4350900 10113848 1,750.00 OTHER CONT SERVICES Cl 04ARDON LABORATORIES Corporate Service&Research Center Invoice No. 10113848 7300 Tussing Road Reynoldsburg,Ohio 43068 1.800.848.9526 Fax: 614.759.2558 Web:www.chardonlabs.com . . TO: TO: ACCOUNTS PAYABLE JOHN DUFFY CITY OF CARMEL-DEPT OF ADMIN CARMEL ENERGY CENTER ONE CIVIC SQUARE 777 THIRD AVENUE SW CARMEL, IN 46032 CARMEL, IN 46032 To include the applicable chemicals&service outlined in Schedule 12 for Cooling Towers,Schedule 13 for Steam Boilers and/or Schedule 14 for Closed Systems. For detailed information on these schedules,please see you Master Service Agreement. CUSTOMER • NO. TERMS SALES PERSON • • INVOICE NET 30 297709 7/16/2014 ITEM • I DESCRIPTION ZSERVICE PowerPurefTower/Loop service 1,750.00 1.00 1,750.00 Submitted T® AUG 112014 Clerk `treasurer REMIT TO: CHARDON LABORATORIES, INC. ACCOUNTS RECEIVABLE Sales Total 1,750.00 7300 TUSSING ROAD Trade Discount 0.00 REYNOLDSBURG, OHIO 43068 Shipping&Handling 0.00 Misc.Charges 0.00 We hereby certify that goods used in conjunction with these services were produced in compliance with all applicable Tax Total 0.00 requirements of Sections 6,7 and 12 of the Fair Labor Standards Act,as amended and on regulation and orders of the 1,750.00 United States Department of Labor issued under Section 14,thereof. Afinance charge of 1.5%per month,18%annum,will be added to overdue invoices. Less Paid Amount 0.00 • ('1,750.00 VOUCHER NO. WARRANT NO. Chardon Laboratories ALLOWED 20 IN SUM OF$ 7300 Tussing Road Reynoldsburg, OH 43068 $1,750.00 ON ACCOUNT OF APPROPRIATION FOR Building Operations Account PO#/Dept. INVOICE NO. ACCT#/TITLE AMOUNT Board Members 1208 I 10113848 I -509.00 I $1,750.00 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 Monday,August 11, 2014 Director,Adminstration Title i 1 Cost distribution ledger classification if claim paid motor vehicle highway fund 4 I 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 service rendered, by whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc. Payee Purchase Order No. Terms Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s)or bill(s)) 07/16/14 10113848 Energy Center $1,750.00 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 , 20 Clerk-Treasurer