251748 11/18/15 J�% " � CITY OF CARMEL, INDIANA VENDOR: 00353237
® ; ONE CIVIC SQUARE TESTAMERICA LABORATORIES, INC CHECK AMOUNT: S..... 119.70'
�� ;_�; CARMEL, INDIANA 46032 PO BOX 204290 CHECK NUMBER: 251748
MUTON�. DALLAS TX 75320-4290 CHECK DATE: 11/18/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 24170478 119.70 OTHER EXPENSES .
TestAmerica
THE LEADER IN ENVIRONMENTAL TESTING
Invoice/Credit No. 24170478 Invoice Date July 24,2015
Terms See Below Federal Tax ID 23-2919996
Remit to TestAmerica Laboratories Inc.PO BOX 204290,Dallas,TX 75320-4290
Bill to: Ship to:
Carmel WWTP Carmel WWTP
Attn:Accounts Payable 30 West Main Street
30 West Main Street Suite 220
Suite 220 Carmel,IN 46032
Carmel,IN 46032
----P.O.Number- - W.O.Number Contract Number Work Ordered b
HORTON Teresa Lewis
248 625-7711
Job Description Site Name SDG Number Invoice Contact
See below Teresa Lewis
Job No. Job Description Receipt Date Quantity Unit Price Amount
Method/Test Description
J53176-1 Horton 07/15/2015
335.4-Cyanide,Total 1.00 30.00 30.00
200.7 Rev 4.4-Total Recoverable Cadmium 1.00 12.00 12.00
200.7 Rev 4.4-Total Recoverable Chromium 1.00 12.00 12.00
200.7 Rev 4.4-Total Recoverable Copper 1.00 12.00 12.00
200.7 Rev 4.4-Total Recoverable Lead 1.00 12.00 12.00
200.7 Rev 4.4-Total Recoverable Nickel 1.00 12.00 12.00
200.7 Rev 4.4-Total Recoverable Silver 1.00 12.00 12.00
200.7 Rev 4.4-Total Recoverable Zinc 1.00 12.00 12.00
Environmental Management Fee 1.00 5.70 5.70
Project Number Client Number Project Manager Subtotal $119.70
24009460 1406871 Amy McCormick
Latest Sample Recei t Date Latest Report Date Phone Number Total $119.70
07/15/2015 07/24/2015 330 966-9787
For proper credit,please include invoice number on all remittance.
TestAmerica Canton-4101 Shuffel Street NW,North Canton,OH 44720
This invoice falls under TestAmerica Laboratories Inc.Standard T&C's of Net 30 Days unless superseded by another valid contract vehicle in Page 1 of 1
place at the time these services were rendered.
VOUCHER # 156637 WARRANT # ALLOWED
00353237 IN SUM OF $
TESTAMERICA INC
PO BOX 99742
Chicago, IL 60690
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO# INV# ACCT# AMOUNT Audit Trail Code
24170478 01-7352-05 $119.70
�I
i
Voucher Total $119.70
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
00353237
TESTAMERICA INC Purchase Order No.
PO BOX 99742 Terms
Chicago, IL 60690 Due Date 11/10/2015
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/10/201! 24170478 $119.70
I hereby certify that the attached invoice(s), or bill(s) is (are)true and
correct and I have audited same in accordance with 1C 5-11-10-1.6
Date Officer