186536 06/09/2010 a- CITY OF CARMEL, INDIANA VENDOR: 360690 Page 1 of 1
ONE CIVIC SQUARE JOHN THOMAS
CHECK AMOUNT: $105.75
CARMEL, INDIANA 46032 11576 CREEKSIDE LANE
CARMEL IN 46033 CHECK NUMBER: 186536
CHECK DATE: 6/9/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
206 4462838 060110 105.75 STORM WATER PHASE II
Page 1 of 1
A
Order Confirmation
Web Confirmation Number: 105931695
Updated On: 06 -01 -10
Source: Web
ITEMS LIST
Line Product Item Qty US Price Total Price
1 1440042 1000 pS /cm Conductivity Standard; 491 mg /L NaCl, 100 mL 1 $13.15 $13.1.5
2 2507200 pH Color Buffer Solution Kit, 4L Each (pH 4.01, pH 7.00, pH 10.01) 1 $76.65 $76.65
Subtotal: $89.80
Shipping: $15.95
Total (before Taxes): $105.75
CONTACT INFORMATION
Name: Sara McMullen
Phone: 317 -571 -2314
e -mail: smcmullen @carmel.in.gov
BILLING ADDRESS SHIPPING ADDRESS
Company: CARMEL ENGINEERING DEPT Company: CARMEL ENGINEERING DEPT
Dept /Div: Dept /Div:
Attn name: Attn /Rcvng:
Address: 1 CIVIC SQ Address: 1 CIVIC SQ
City: CARMEL City: CARMEL
State: Indiana State: Indiana
Zip: 46032 -7569 Zip: 46032 -7569
Country: United States Country: United States
Phone: Phone:
Fax:
PAYMENT
P.O. Number: 21816
Credit Card Number:
Credit Card Expiration: 06 -11
Credit Card Holder Name: John G Thomas
Credit Card Ref. Number:
Tax Exempt order: Yes
Promotions Reward Program
Offer Code:
P3 Account Number:
SHIPPING DETAILS FREIGHT INFORMATION
Freight Payment Method
Freight Payment Method: Pre -paid
Shipping Options and Shipping Method
Shipping Option: Ship order complete
Shipping Method: Standard surface shipping
TERMS
Orders containing hazardous items may require special shipping. If changes to your shipping method are required, you will be notified by
Hach customer service.
You will receive an e-mail confirmation which will include the details of this order, including taxes and your confirmation number.
Comments: No comments or special instructions entered.
https: /www.hach .cons /hc /D0C.TXDOC.EXECUTE ACTION_']X_DOC /Procurement /Po 6/1/2010
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
John Thomas
Purchase Order No.
Lngineering Department
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
06/01/10 n/a Storm Water Testing Supplies $105.75
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
Jehn Thomas IN SUM OF
Engineering Dept.
$105.75
ON ACCOUNT OF APPROPRIATION FOR
Department of Engineering
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
n/a 6/1/2010 206 4462838 $105.75
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
(Q 20
Signature
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund