248269 08/12/15 CITY OF CARMEL, INDIANA VENDOR: 00352978
ONE CIVIC SQUARE CHEMSEARCH CHECK AMOUNT: $"*"****420.50*
CARMEL, INDIANA 46032 23261 NETWORK PLACE CHECK NUMBER: 248269
CHICAGO IL 60673-1232 CHECK DATE: 08/12/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 1986774 420.50 OTHER EXPENSES
.E..�. .._m INVOICE Page: 1 of 1
CORRESPONDENCE TO
ORIGINAL COPY Remittance Address
PO BOX 152170 CHEMSEARCHFE
IRVING TX 75015 REORDERS CALL #1-800-527-9921 23261 NETWORK PLACE
FAX #1-972-438-0634 CHICAGO,IL 60673-1232
W W W.CHEMSEARCHFE.COM
Sold To Ship To We are going green!
Attn: ACCOUNTS PAYABLE
CITY OF CARMEL To pay electronically or
CITY OF CARMEL UTILITIES / OPERATIONS
UTILITIES / PLANT MAINTENANCE FOREMAN receive invoices via
3450 W 131ST ST PLANT MAINTENANCE 4915 E
WESTFIELD IN 46074 106TH ST email or fax-
CARMEL IN 46033
simply contact us at
cac.credit@nch.com
Customer No. Billing Date Terms Due Date Ship Date Sales Order
441468 22-JUL-15 10 NET 01-AUG-15 22-JUL-15 2136953
Invoice No. Purchase Order No. .Sales RepNo. Sales Rep.Name
1986774 KR50115 USFEF001 DUNSCOMB,Mr.JAMES L
Product I Qty Ordered ,Description Packaging I. Qty Billed I Unit Price Amount
12034200 1 TANK TONIC,QUART,US CM EA 1.00 66.55 66.55
10171701 1 DIESEL GUARD 2000 ALL SEASONS,2 X 2.5 GL,NAC NC GL 5.00 64.86 324.30
Merchandise State Tax Local Tax
"Shipping SplitTnv.No. Currency Total Amount'
390.85 0.00 0.00 29.65 USD 420.50
IN Tax ED#0003512371-001-3 Federal ID#75-0457200
C-HEMSEAP.CH FE,DIVSIOP:-OF-NCH-CORPOPF.TION:AL-L-PL•TURPIS-CLAIMS-FOP.-ERP.ORS-OP.:SDJUSTMENTS-OF ANY KIND-MUST BE
MADE -
VOUCHER # 152741 WARRANT# ALLOWED
352978 IN SUM OF $
CHEMSEARCH
23261 NETWORK PLACE
CHICAGO, IL 60673-1232
r
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
1986774 01-6200-04 $420.50
r,
Voucher Total $420.50
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
i
352978
CHEMSEARCH Purchase Order No.
23261 NETWORK PLACE Terms
CHICAGO, IL 60673-1232 Due Date 8/7/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
I
8/7/2015 1986774 $420.50
i
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