183761 03/29/2010 CITY OF CARMEL, INDIANA VENDOR: 194400 Page 1 of 1
j ONE CIVIC SQUARE CHEM -AQUA, INC
CARMEL, INDIANA 46032 23261 NETWORK PLACE CHECK AMOUNT: $200.29
CHICAGO IL 60673 -1232 CHECK NUMBER: 183761
CHECK DATE: 3/29/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350100 602432 200.29 BUILDING REPAIRS MA
ORIGINAL
CIf4 Y„A IN V OICL
We Treat Your water Right' REORDERS CALL CHEMAQ UA
N'
CORRESPO ENCETO: 1- 800 -rJ27 -9921 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 To enroll ,please call
CARMEL IN 46032
1- 800 -527- 9919 -x0831
Cust. Aect. No.1 invoice No. I invoice Date Terms Sales Reo I Order No. I Ship Date. I Customer P.O. No.
CB002439 602432 03 -16 -10 NET 10 DAYS I 7C34 I 0713C 03 -15 -10
PFod _Uct Pnchai in Description Unit Price �tv .Billed I Amount
X005 1 WATER TRTMT PROD /OR SVC 200.29 1EA 200.29
Merchandise State Tax Local Tax *Shi I )inR Inv. Total Amount
200.29 1 200.29
IN Tax #0101073755-001-0 Federalld #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. 11 DISTRIRUf ION SERVICES INCLUDE SHIPPING 6 HANDLING CHARGES F.O.B. OELVD.
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))
3/16/10 602432 monthly a e
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
CltiamAqua
IN SUM OF
23261 Network Place
icago, IL
200.29
ON ACCOUNT OF APPROPRIATION FOR
police generl afund
Board Members
PT INVOICE NO. ACCT /TITLE AMOUNT I hereby certify that the attached invoice(s), or
1110 602432 501 200.291 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
March 24 20 10
Signature
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund