184258 04/14/2010 CITY OF CARMEL, INDIANA VENDOR: 355990 Page 1 of 1
ONE CIVIC SQUARE ENVIRONMENTAL LABORATORIES INC
CARMEL, INDIANA 46032 635 GREEN ROAD CHECK AMOUNT: $790.00
PO BOX 968 CHECK NUMBER: 184258
MADISON IN 47250
CHECK DATE: 4114/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 R5023990 W09060 20101386 790.00 TESTING
�Y
Phvironmental
Invoice Lawratori.es j inc.
635 Green Road, PO Box 968, Madison, IN 47250
Tel: 812.273.6699 Fax: 812.273,5788
Bill To: Invoice M.: 20101386
Accounts Payable Invoice Date: 3/14/2010
CARMEL UTILITIES Order No.: 2010020562
3450 W. 131st STREET PO No.:'
WESTFIELD, IN 46074
�u
'K
77 7
h.0 hJff;Cost'-'�
77 �77
n� Total
r va 4
HAA5 3 $190.00 $570.00
State Forwarding Fee 1 $10m $10.00
Total THM 3 $70.00 $210.00
(Fold and Cut Here) Invoice Total: $790.00
VOUCHER 101261 WARRANT ALLOWED
u
355990 IN SUM OF
ENVIRONMENTAL LABOR P IES, IN
635 GREEN RD.
P.O. BOX 968�L`+
MADISON, IN 47250 0'�e��
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
q
20101386 01- 6350 -03 $790.00
Voucher Total $790.00
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
355990
ENVIRONMENTAL LABORATORIES, INC. Purchase Order No.
635 GREEN RD. Terms
P.O. BOX 968 Due Date 4/1/2010
MADISON, IN 47250
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/1/2010 20101386 $790.00
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