181992 02/03/2010 F CITY OF CARMEL, INDIANA VENDOR: 363758 Page 1 of 1
ONE CIVIC SQUARE LABSOURCE CHECK AMOUNT: $987.07
E CARMEL, INDIANA 46032 97400 EAGLE WAY
J �r CHI CAGO IL 60678 -9740
�o CHECK NUMBER: 181992
CHECK DATE: 2/3/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 S11935 787388 246.70 LAB SUPPLIES
651 5023990 S11935 788205 83.96 LAB SUPPLIES
651 5023990 S11935 788261 656.41 LAB SUPPLIES
i
Remit To
LABSOURCE, INC
97400 Eagle Way
Chicago, IL 60678-9740
PH: 800- 545 -8823 FAX: 630 343 -1701 FEIN #36 3631684 LabSource
Invoice 788261
Date 01/21/2010
PO# S11935
Bill To Ship To
City of Carmel City of Carmel
Teresa Lewis Teresa Lewis
Wastewater Lab Wastewater Lab
9609 Hazel Dell Pkwy 9609 Hazel Dell Pkwy
Indianapolis, IN 46280 Indianapolis, IN 46280
Customer Ship Via FOB Terms
NONCUS UPS Ground Commercial Origin NET 30 DAYS
Purchase Order Salesperson Order Date •Sales `Order
S11935 AF 01/07/2010 671766
Quantity
Line UOM Catalog Description Price Extended
Ord Ship BO
1 2 2 0 PK 13- 297 -200 POLYSEED CAPSULES 50 /PK $99.00 $198.00
2 1 1 0 EA 07- 578 -3B DRIERITE INDICAT 8 MESH 5LB $49.43 $49.43
j 3 3 3 0 PK 14- 853 -22 HYDRION REFILL 1 -12 5 /PK $7.08 $21.24
4 1 0 1 EA 34108 -041 SOLUTION PH STORAGE 475ML $35.75 $0.00
5 5 5 0 PK AP4004700 GLASS FIBER FILTER 47MM 100PK $39.69 $198.45
6 1 1 0 CS 04 -355 -4 DRI CONTRAD POWDER DETERG 2KG $145.99 $145.99
7 `2 0 2 EA 02 -964 -12 PAPER F /PRINTER 2340 25403870 $9.08 $0.00
8 2 0 2 EA 13 -641 -883 AMMONIA PH ADJUSTING ISA $61.49 $0.00
haz
Subtotal $613.11
Shipping Handling $21.30
Hazard Fee $22.00
Invoice.Total 1' $656.41
Page 1 of 1
VOUCHER 097234 WARRANT ALLOWED
363758 IN SUM OF
LABSOURCE E'4
Cully
CA L 4pQ _IL (6 78
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
788261 01- 7202 -05 $613.11
788261 01- 7202 -05 $43.30
5 P
Voucher Total $656.41
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
363758
LABSOURCE Purchase Order No.
1186 ARBOR DRIVE
Terms
ROMEOVILLE, IL 60446 Due Date 1/28/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/28/2010 788261 $656.41
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.
/.7q,„
Date Officer
Remit To
LABSOURCE, INC
97400 Eagle Way
Chicago, IL 60678-9740 LabSource
PH: 800- 545 -882-882 3 FAX: 630 343 -1701 FEIN #36 3631684 e
Invoice 788205
Date 01/21/2010
PO# S11935
Bill To Ship To
City of Carmel City of Carmel
Teresa Lewis Teresa Lewis
Wastewater Lab Wastewater Lab
9609 Hazel Dell Pkwy 9609 Hazel Dell Pkwy
Indianapolis, IN 46280 Indianapolis, IN 46280
Customer Ship Via :,FOB Terms
NONCUS UPS Ground Commercial Origin NET 30 DAYS
Purchase Order Salesperson Order Date' Sales Order
S11935 AF 01/07/2010 671766
Quantity
Line Ord Ship B0 UOM Catalog Description Price .Extended
1 2 0 2 PK 13 -297 -200 POLYSEED CAPSULES 50 /PK $99.00 $0.00
2 1 0 1 EA 07- 578 -3B DRIERITE INDICAT 8 MESH 5LB $49.43 $0.00
3 3 0 3 PK 14- 853 -22 HYDRION REFILL 1 -12 5 /PK $7.08 $0.00
.4 5 5 0 PK P22 -272 Finntip 10m1, Bulk, Bagged, 100 /pk $15.53 $77.65
L 5' 1 0 1 EA 34108 -041 SOLUTION PH STORAGE 475ML $35.75 $0.00
6 5 0 5 PK AP4004700 GLASS FIBER FILTER 47MM 100PK $39.69 _$0.$0.00
1 0 1 CS 04 -355 -4 DRI CONTRAD POWDER DETERG 2KG $145.99 00
1 .8 2 0 2 EA 02- 964 -12 PAPER F /PRINTER 2340 25403870 $9.08 $0.00
9 2 0 2 EA 13- 641 -883 AMMONIA PH ADJUSTING ISA $61.49 $0.00
haz
Pkg 1- 1Z22E4360306349641
Subtotal $77.65
Shipping Handling $6.31
Invoice Total $83.96
Page 1 of 1
Remit To
LABSOURCE, INC
97400 Eagle Way
Chicago, IL 60678-9740 LabSource
PH: 800-545-8823 545 --88823 3 FAX: 630 343 -1701 FEIN #36 3631684
Invoice 787388
Date 01/08/2010
PO# S11935
Bill To Ship To
City of Carmel City of Carmel
Teresa Lewis Teresa Lewis
Wastewater Lab Wastewater Lab
9609 Hazel Dell Pkwy 9609 Hazel Dell Pkwy
Indianapolis, IN 46280 Indianapolis, IN 46280
Customer Ship Via FOB Terms
NONCUS UPS Ground Commercial Origin NET 30 DAYS
Purchase Order Salesperson Order Date Sales Order
S11935 AF 01/07/2010 671766
Line Quantity UOM Catalog Description Price Extended
Ord Ship BO
1 2 0 2 PK 13- 297 -200 POLYSEED CAPSULES 50 /PK $99.00 $0.00
2 4 4 0 CS N853 Gloves, Nitrile, Blue, Powder -Free, Textured, $53.00 $212.00
Large, 100/pk, 1000 /cs
3 1 E A d 7-578 -B 0 1 3 DRIERITE INDICAT 8 MESH 5LB _$49.43 $0.00
4• 3 0 3 PK 14- 853 -22 HYDRION REFILL 1 -12 5 /PK $7.08 $0.00
5 5 0 5 PK P22 -272 Finntip 10ml, Bulk, Bagged, 100 /pk $15.53 $0.00
6 1 0 1 EA 34108 -041 SOLUTION PH STORAGE 475ML $35.75 $0.00
7 5 0 5 PK AP4004700 GLASS FIBER FILTER 47MM 100PK $39.69 $0.00
78 1 0 1 CS 04 -355 -4 DRI CONTRAD POWDER DETERG 2KG $145.99 $0.00
9 2 0 2 EA 02-964-12 PAPER F /PRINTER 2340 25403870 $9.08 $0.00
10 2 0 2 EA 13- 641 -883 AMMONIA PH ADJUSTING ISA $61.49 $0.00
haz
Pkg 1- 1Z22E4360306336762
Pkg 2- 1Z22E4360306336771
Pkg 3 1Z22E4360306336780 Subtotal $212.00
Pkg 4 1Z22E4360306336799 Shipping Handling $34.70
Invoice Total $246.70
Page 1 of 1
VOUCHER 0971.54. WARRANT ALLOWED
363758 IN SUM OF$
LABSOURCE_
1-186- AR C R-- BLV -E--- �y_ d
RthatOVItt E1E 60446
C' h -c`c 9 .T L. GDG78'
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
787388 01- 7202 -05 $212.00
787388 01- 7202 -05 $34.70
/4W05 °/./1..02.°5 5 3 ,E
a 35
Voucher Total -246
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
363758
LABSOURCE Purchase Order No.
1186 ARBOR DRIVE Terms
ROMEOV1LLE, IL 60446 Due Date 1/25/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
1/25/2010 787388 $246.70
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer