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242221 02/17/15 � ( I CSN . M�. CITY OF CARMEL, INDIANA VENDOR: 358403 ® ONE CIVIC SQUARE CHARDON LABORATORIES INC CHECK AMOUNT: $******"250.00* 4 CARMEL, INDIANA 46032 ACCTS RECEIVABLE CHECK NUMBER: 242221 7300 TUSSING ROAD CHECK DATE: 02/17/15 REYNOLDSBURG OH 43068 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 I0121922 250.00 OTHER EXPENSES � I 04AR©ON L.A®ORAToR ES / Corporate Service&Research Center Invoice No. 10121922 7300 Tussing Road Reynoldsburg,Ohio 43068 1.800.848.9526 Fax: 614.759.2558 Web: www.chardonlabs.com PAUL ARNONE 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 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. o W 1o o • • D NET 30 MARK HEIRBRANDT 209396 1/16/2015 0 D 0 p D D ZSERVICE Loop Service 250.00 1.00 250.00 REMIT TO: CHARDON LABORATORIES, INC. ACCOUNTS RECEIVABLE Sales Total 250.00 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 250.00 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 ® 250.00 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 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 2/11/2015 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 2/11/2015 10121922 $250.00 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 # 146740 WARRANT # ALLOWED 358403 IN SUM OF $ 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 10121922 01-7362-06 $250.00 i Voucher Total $250.00 Cost distribution ledger classification if claim paid under vehicle highway fund