186913 06/23/2010 .\.f CITY OF CARMEL, INDIANA VENDOR: 363758 Page 1 of 1
ONE CIVIC SQUARE LABSOURCE
0 CHECK AMOUNT: $761.85
CARMEL, INDIANA 46032 97400 EAGLE WAY
CHICAGO IL 60678 -9740 CHECK NUMBER: 186913
CHECK DATE: 6/23/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 797788 671.88 OTHER EXPENSES
651 5023990 797820 89.97 OTHER EXPENSES
Remit To
LABSOURCE, INC
97400 Eagle Way
Chicago, IL 60678 -9740 L abSource
PH: 800 5445 -8823 •FAX: 630- 343 -1701 FEIN #36 3631684
Invoice 797820
Date 05/18/2010
PO# S12152
Bill To Ship To
City of Carmel City of Carmel
Tara Washington Tara Washington
Wastewater Lab Wastewater Lab
9609 Hazel Dell Pkwy 9609 Hazel Dell Pkwy
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:
S12152 AF 05/11/2010 680043
Line Quantity UOM Catalog Description Price Extended
Ord Ship BO
1 1 0 1 EA 13- 302 -32 DO PROBE MAINT KIT $115 $0.00
2 2 0 2 EA 13- 641 -883 AMMONIA PH ADJUSTING ISA $61 $0.00
3 1 0 1 EA 13 -642 -545 PH ATC EPDXY GEL TRIOBE $181.00 $0.0
4 4 4 0 PK 89090446 -PK CYLNDR GRAD TD CLSA 100ML PK1 $20.00 $80.00
Subtotal $80.00
Shipping Handling $9.97
Invoice Total $89.97
Page 1 of 1
Remit To
LABSOURCE, INC
97400 Eagle Way
Chicago, IL 60678 -9740 L ab Sourc e�
PH: 800 545 -882- 8823 .3 •FAX: 630 343 -1701 FEIN #36 3631684
Invoice 7977$$
Date 05/18/2010
PO# S12152
Bill To Ship To
City of Carmel City of Carmel
Tara Washington Tara Washington
Wastewater Lab Wastewater Lab
9609 Hazel Dell Pkwy 9609 Hazel Dell Pkwy
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.
S12152 AF 05/11/2010 680043
Line Quantity UOM Catalog Description Price Extended
Ord Ship BO
1 1 0 1 EA 13- 302 -32 DO PROB KIT $115.00 $0.00
�2 2 0 2 EA 13- 64 -883 AM MONIA PH ADJUS G ISA $61. $0.00
3 2 2 0 PK 1 297 -20 POLYSEED CAPSULES 50 /PK $99.00 $198.00
�4 5 I 5_ 0 P A GLASS FIBER F 4 7MM_1_00PK $39. $198.45
�5 1 _0 1 _EA 13- 642 -5 45 PH /AT EPDXY GEL TRI $181.00 $0.00
6. 3 3 0 �PK 1 853 -22 HYDRIO REFILL 1 -12 57P $7:08 21.24
7 6 6 0 EA 04 -355 -4 DRI CONTRAD POWDER DETERG 2K $34.55 $207.30
8 4 0 4 PK 89090446 -PK CYLNDR GRAD TD CLSA 100ML PK1 $20 .00 $0.00
Subtotal $624.99
Shipping Handling $24.39
Hazard Fee $22.50
Invoice Total $fi 71 88
Page 1 of 1
V
VOUCHER 105636,, WARRANT ALLOWED
363758 IN SUM OF
LABSOURCE
1186 ARBOR DRIVE
ROMEOVILLE, IL 60446
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
797788 01- 7202 -05 $624.99
797788 01- 7202 -05 $46.89
7R 7 ,0 01.-7 202.05, a�a�
Voucher Total U r$5
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
363758
LABSOURCE Purchase Order No.
1186 ARBOR DRIVE Terms
ROMEOVILLE, IL 60446 Due Date 6114/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/1 4/2010 797788 $671.88
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