181849 02/03/2010 CITY OF CARMEL, INDIANA VENDOR: 194400 Page 1 of 1
(.7; ONE CIVIC SQUARE CHEM -AQUA, INC
CARMEL, INDIANA 46032 23261 NETWORK PLACE CHECK AMOUNT: $200.29
a �;0 CHICAGO IL 60673 -1232 CHECK NUMBER: 181849
r
CHECK DATE: 2/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350100 592777 200.29 BUILDING REPAIRS MA
ORIGINAL E
CI-EM-AG A INVOICE
We Treat your water Right' REORDERS CALL: 1 -800- 527 -9921 CHEMAQUA
CORRh:SPONOENCE TO 23261 NETWORK PLACE
P.O. BOX 152170 FAX 1- 972 438 -0634 CHICAGO, IL 60673 -1232
IRVING,TExAS 75015
www.CHEMAQUA.com
SOLD TO: SHIPPED TO:
Electronic Funds Transfer
(EFT)
CARMEL POLICE STATION
3 CIVIC SQ payments are encouraged
CARMEL POLICE STATION CARMEL IN
3 CIVIC SQ 46032
CARMEL IN 46032 To enroll please call
1- 800 -52 7 -9919 -x0831
Cust. Acct. No. Invoice No. Invoice Date Terms Sales Rep Order No. Ship Date Customer P.O. No.
CB002439 592777 01 -18 -10 INET 10 DAYS 7C34 0713A 01 -15 -10
Product Packaging 1 Deserintion 1_Unit_ I_Oty_ Billed Amount
X005 1 WATER TRTMT PROD /OR SVC 200.29 1EA 200.29
Merchandise State Tax Local Tax Shipping Inv. Total Amount
200.29 200.29
IN Tax 0101073755 -001 -0 Federal Id #75- 2761907
CHEM -AQUA, INC., ALL RETURNS, CLAIMS FOR ERRORS OR ADJUSTMENTS OF ANY KIND
MUST BE MADE WITHIN 15 DAYS AFTER RECEIPT OF GOODS. MERCHANDISE NOT ACCEPTED FOR CREDIT WITHOUT OUR PRIOR
WRITTEN CONSENT. "DISTRIBUTION SERVICES INCLUDE SHIPPING HANDLING CHARGES F.O.H, DELVD.
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
ChemAqua Purchase Order No.
23261 Network Place Terms
Chicago, IL 60673 -1232 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
1/18/10 592777 monthly payment 200.29
Total
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.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
CfiemAqua IN SUM OF
23261 Network Place
Chicago, IL 60673 -1232
200.29
ON ACCOUNT OF APPROPRIATION FOR
police generallfund
Board Members
P or NO. #/TITLE AMOUNT hereby certify invoice(s), INVOICE NO ACCT I hereb certif that the attached invoices or
1110 592777 501 200.29 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
January 27 20 10
Signature
Chief of POlice
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund