251161 11/04/15 CITY OF CARMEL, INDIANA VENDOR: 358238
.�; ® • ONE CIVIC SQUARE LABCHEM INC CHECK AMOUNT: $*"""***209.06*
f. CARMEL, INDIANA 46032 1010 JACKSON'S POINTE COURT CHECK NUMBER: 251 161
BLDG 1000 CHECK DATE: 11/04/15
ZELIENOPLE PA 16063
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 918113 209.06 OTHER EXPENSES
INVOICE
JLahChem Invoice ID :918113
Sales Order ID :924349
performance through chemistry Invoice Date : 10/20/2015
Jackson's Pointe Commerce Park-Building 1000 Ship Date 10/20/2015 1:59:00 PM
1010 Jackson's Pointe Court,Zelienople,PA 16063 Customer PO ID SS15530
Ph:412-826-5230 I Fax:724-473-0647 1 www.labchem.com
Page Number : I of 1
AR Terms: Due Date: Amount Due:
Net 30 Days 11/19/2015 $209.06
Bill To: 1265 Ship To
CARMEL WWTP CARMEL WWTP
9609 HAZEL DELL PKWY 9609 HAZEL DELL PKWY
INDIANAPOLIS,IN 46280 INDIANAPOLIS,IN 46280-2935
USA USA
Order Date: 10/16/2015 1:11:24 PM FOB: Zelienople,PA
Packing Slip: 520594 Currency Type: USD
Ship Method: FedEx Ground Service
Line Nbr Item ID/Item Name Unit of Shipped Unit Price Sales Tax Extra Extended
Cust Item ID Measure Qty Charges Price
1 LC148451/GLUCOSE-GLUTAMIC ACID EA 5.0000 $35.3000 0.00% $0.0000 $176.50
B/O Qty: 0.0000
Lot Number Expiration Date Lot Trans Oty
E240-07 09/14/2017 5
Line Item Total: $176.50
2 LCI88501/POTASSIUM CHROMATE INDICATOR EA 1.0000 $18.7000 0.00% $0.0000 $18.70
B/O Qty: 0.0000
Lot Number Expiration Date Lot Trans Otv
E230-02 08/19/2017 1
Line Item Total: $18.70
Subtotal: $195.20
Sales Tax: $0.00
Tracking Numbers:
Shipping Charges: $13.86
653810087303 Total: $209.06
Form#34.02 06/19/2012 See"www.labchem.com"for C of A and MSDS information All Products Made In USA
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
358238
LABCHEM INC Purchase Order No.
1010 JACKSON'S POINTE COURT Terms
ZELIENOPLE, PA 16063 Due Date 10/27/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/27/201! 918113 $209.06
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
bo
Date Officer
VOUCHER # 156522 WARRANT # ALLOWED
358238 IN SUM OF $
LABCHEM INC
1010 JACKSON'S POINTE COURT
ZELIENOPLE, PA 16063
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
918113 01-7202-05 $209.06
Voucher Total $209.06
Cost distribution ledger classification if
claim paid under vehicle highway fund