303608 09/29/16 (9,
CITY OF CARMEL, INDIANA VENDOR: 355990
ONE CIVIC SQUARE ENVIRONMENTAL LABORATORIES INC CHECK AMOUNT: $'*"**«'88.00•
CARMEL, INDIANA 46032 PO BOX 968 CHECK NUMBER: 303608
MADISON IN 47250 CHECK DATE: 09/29/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1094 4350900 20216860 88.00 OTHER CONT SERVICES
Voucher No. Warrant No.
355990 Environmental Laboratories, Inc. Allowed 20
P.O. Box 968
Madison, IN 47250
In Sum of$
$ 88.00
ON ACCOUNT.OF APPROPRIATION FOR
109 Monon Center
PO#or INVOICE NO. ACCT#/TITLE AMOUNT Board Members
Dept#
1094 20216860 4350900 $ 88.00 1 hereby certify that the attached invoice(s), or
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
September 21, 2016
'P*h&MhUA)
Signature
$ 88.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
355990 Environmental Laboratories, Inc. Terms
P.O. Box 968
Madison, IN 47250
Invoice Invoice Description
Date Number (or note attached invoice(s)or bill(s)) PO# Amount
9/19/16 20216860 Pool Water Testing MCC 9/13/16 40382 $ 88.00
Total $ 88.00
1 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
, 20
Clerk-Treasurer
Laboratory Invoice 20216860
Q lmental
Invoice Date: 09/19/2016 pries
635 Green Road;PDBoxi968 Madison;1N 47250 )
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Billing Information uff a>Ice Nom. "202168 0 c'
Paula Schlemmer InvoicepD to ' "=09/19/2016
Carmel-Clay Parks-Monon Community Center Samples Received: 09/13/2016
1411 E. 116th St. Order No.: 2016090602
Indianapolis, IN 46280 PO No.:
Project description:
QU11t[t)l?;.. '.fAq111t� CSSt
Collection Fee Per Sample 4 $4.00 $16.00
Pool Analysis 4 $18.00 $72.00
RECEIVED
SE? 2 0 2016
BY:
(Fold and Cut Here) Invoice Total: