186784 06/23/2010 CITY OF CARMEL, INDIANA VENDOR: 361475 Page 1 of 1
0 ONE CIVIC SQUARE DAILY LABORATORIES
CARMEL, INDIANA 46032 2200 W ALTORFER SUITE B CHECK AMOUNT: $120.00
PEORIA IL 61615
CHECK NUMBER: 186784
CHECK DATE: 6123/2010
DEPARTMENT ACCOUNT P O NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 3936 120.00 CONT SVS- TESTING -S PL
Daily Laboratories
Division of Mobilab, Inc. I n V Q
o i ce
2200 W. Altorfer Dr. Suite B
Number: 3936
Peoria, IL 61615
(309) 691 -4513 Date: June 04, 2010
Bill T Ship To:
Tara Rubush
City of Carmel WWTP
9609 Hazel Dell Pkwy
Indianapolis, IN 46280
P.O. Number Terms Project
tars 30 days 05/26110
Date Quantity Description Price Each Amount
06/01 1 Suitability test on distilled water 120.00 120.00
Total $120.00
I/
VOUCHER 105681 WARRANT ALLOWED
361475 IN SUM OF
DAILY LABORATORIES 220o w /farPf,(Jil
5 2.0_B -IG HQ 9 R 49AD—
PEORIA, IL 61615
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
%3.32
3936 01- x.362-05 $120.00
Voucher Total $120.00
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
361475
DAILY LABORATORIES Purchase Order No.
5120 BIG HOLLOW ROAD Terms
PEORIA, IL 61615 Due Date 6/16/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/16/2010 3936 $120.00
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