HomeMy WebLinkAbout253845 01/26/16 CITY OF CARMEL, INDIANA VENDOR: 358403
�i ONE CIVIC SQUARE CHARDON LABORATORIES INC CHECK AMOUNT: $*******250.00*
CARMEL, INDIANA 46032 ACCTS RECEIVABLE CHECK NUMBER: 253845
9M��oN 0 7300 TUSSING ROAD CHECK DATE: 01/26/16
REYNOLDSBURG OH 43088
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 I0139017 250.00 OTHER EXPENSES
Q-A M LABORATORIES
Corporate Service&Research Center Invoice No. 10139017
7300 Tuss ng Road
Reynoldsburg,Ohio 43068
1.800.848.9526
Fax:614.759.2558
Web:www.chardonlabs.com
• . TO:
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. _
CUSTOMER P.O.NO. TERMS SALESPERSON CUSTOMER NO. INVOICE DATE
NET 30 MARK HEIRBRANDT 209396 1/16/2016
ITEM • DESCRIPTION UNIT PRICE QTY EXTENDED PRICE
ZSERVICE Loop Service 250.00 1.00 250.00
REMIT TO: CHARDON LABORATORIES, INC. Sales Total 250.00
ACCOUNTS RECEIVABLE
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
Prescribed by State Board of Accounts City Form No.201 (Hev Iwo)
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 1/21/2016
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/21/2016 10139017 $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 # 157074 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
10139017 01-7362-06 $250.00
Voucher Total $250.00
Cost distribution ledger classification if
claim paid under vehicle highway fund