240648 01/07/2015 CITY OF CARMEL, INDIANA VENDOR: 358403
b ONE CIVIC SQUARE CHARDON LABORATORIES INC CHECK AMOUNT: $*******855.00`
CARMEL, INDIANA 46032 7ACCTS RECEIVABLE 300 TOSSING ROAD CHECK NUMBER: 240648
REYNOLDSBURG OH 43068 CHECK DATE: 01/07/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 I0120579 855.00 OTHER EXPENSES
`I
CHARDON LABORATORIES O
Corporate Service&Research Center Invoice No. 10120579
7300 Tussing Road Order No. 00043860
Reynoldsburg,Ohio 43068
1.800.848.9526
Fax: 614.759.2558
Web: www.chardonlabs.com
PAULARNONE JEFF COOPER
CARMEL WASTE WATER TREATMENT CARMEL W W T P
9609 HAZEL DELL PARKWAY 9609 HAZEL DELL PARKWAY
INDIANAPOLIS, IN 46280 INDIANAPOLIS, IN 46280
To include the applicable chemicals-&service outlined-in Schedule 12 for Cooling Tower,,Schedule 13 for Steam Boilers and!or Schedule 14 for C!oeod Systems-For -- ----
detailed information on these schedules,please see you Master Service Agreement.
NET 30 MARK HEIRBRANDT 209396 11/28/2014
FTF2 FILTER VESSEL 2 GALLON FTF-2DB 855.00 1.00 855.00
REMIT TO: CHARDON LABORATORIES, INC. Sales Total 855.00
ACCOUNTS RECEIVABLE
Trade Discount 0.00
7300 TUSSING ROAD Shipping&Handling 0.00
REYNOLDSBURG, OHIO 43068 Misc,Charges 0.00
We hereby certify that goods used in conjunction with these services were produced in compliance with all Tax Total 0.00
applicable requirements of Sections 6,7 and 12 of the Fair Labor Standards Act,as amended and on regulation and 855.00
orders of the United States Department of Labor issued under Section 14,thereof. Less Paid Amount 0.00
Afinance charge of 1.5%per month,18%annum,will be added to overdue invoices.
• 855.00
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
358403
CHARDON LABORATORIES INC Purchase Order No.
7300 TUSSING ROAD Terms
REYNOLDSBURG, OH 43068 Due Date 12/10/2014
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/10/201, 10120579 $855.00
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
Date Officer
VOUCHER # 146220 WARRANT # ALLOWED
358403 IN SUM OF $
I
CHARDON LABORATORIES INC
7300 TUSSING ROAD
REYNOLDSBURG, OH 43068
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
10120579 01-7202-06 $855.00
Voucher Total $855.00
Cost distribution ledger classification if
claim paid under vehicle highway fund
s