184364 04/14/2010 a- CITY OF CARMEL, INDIANA VENDOR: 363758 Page 1 of 1
ONE CIVIC SQUARE LABSOURCE
CHECK AMOUNT: $637.14
CARMEL, INDIANA 46032 97400 EAGLE WAY
CHICAGO IL 60678 -9740 CHECK NUMBER: 184364
CHECK DATE: 4/14/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 S12110 792719 566.46 GLOVES
651 5023990 S12110 792903 70.68 GLOVES
1
Remit To
�o
LABSOURCE, INC
97400 Eagle Way
Chicago, IL 60678 -9740 L ab Soiarce
PH: 800 -545 -8823 •FAX: 630- 343 -1701 FEIN #36 3631684
Invoice 792903
Date 03/24/2010
PO# 031910 -TW
Bill To Ship To
City of Carmel City of Carmel
Teresa Lewis Teresa Lewis
9609 Hazel Dell Parkway 9609 Hazel Dell Parkway
Wastewater Lab Wastewater Lab
INDIANAPOLIS, IN 46280 INDIANAPOLIS, IN 46280
Customer Ship Via FOB Terms
CAR571 UPS Ground Commercial Origin NET 30 DAYS
Purchase Order Salesperson Order Date Sales Order
031910 -TW AF 03119/2010 676502
Line Ord Quantity BO LIOM Catalog Description Price Extended
1 1 1 0 CS N852 Gloves, Nitrite, Blue, Powder -Free, Textured, $62.00 $62.00
Medium, 100 /pk, 1000 /cs
Pkg 1- 1Z22E4360306424587
Subtotal $62.00
Shipping Handling $8.68
Invoice Total $70.68
Page 1 of 1
Remit To
LABSOURCE, INC
97400 Eagle Way
Chicago, IL 60678 -9740 LabSource
PH: 800 545 -8823 FAX: 630 343 -1701 FEIN #36 3631684
Invoice 792719
Date 03/22/2010
PO# 031910 -TW
Bill To Ship To
City of Carmel City of Carmel
Teresa Lewis Teresa Lewis
9609 Hazel Dell Parkway 9609 Hazel Dell Parkway
Wastewater Lab Wastewater Lab
INDIANAPOLIS, IN 46280 INDIANAPOLIS, IN 46280
Customer Ship Via FOB Terms.
CAR571 UPS Ground Commercial Origin NET 30 DAYS
Purchase Order Salesperson Order Date Sales Order
031910 -TW AF 03/19/2010 676502
Line Quantity UOM Catalog Description Price Extended
Ord Ship BO
1 7 8 8 0 CS N853 Gloves, Nitrile, Blue, Powder -Free, Textured, $62.00 $496.00
Lar 100 /pk, 1000 /cs
2 1 0 1 CS N852 Gloves, Nitrile, Blue, Powder -Free, Textured, $62.00 $0.00
Medium, 1001 k, 1000 /cs
Pkg1- 1Z22E4360306421348
Pkg 2 1Z22E4360306421357 Subtotal $496.00
Pkg 3- 1Z22E4360306421366
Pkg 4 1Z22E4360306421375 Shipping Handling $70.46
Pkg 5- lZ22E4360306421384
Pkg 6- 1Z22E4360306421393
Pkg 7 1Z22E4360306421400 Invoice Total $566.46
Pkg 8- lZ22E4360306421419
Page 1 of 1
VOUCHER 105211 WARRANT ALLOWED
363758 IN SUM OF
LABSOURCE
1186 ARBOR DRIVE
ROM��EppO^�VILLE, IL 60446
�I ICU"
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
792719 01- 7202 -05 $496.00
792719 01- 7202 -05 $70.46
l I�
Voucher Total �r5
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 199J)
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 4/7/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/7/2010 792719 $566.46
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