187924 07/21/2010 a CITY OF CARMEL, INDIANA VENDOR: 363758 Page 1 of 1
i ONE CIVIC SQUARE LABSOURCE CHECK AMOUNT: $1,040.95
CARMEL, INDIANA 46032 97400 EAGLE WAY
CHICAGO IL 60678 -9740 CHECK NUMBER: 187924
CHECK DATE: 7/21/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 799987 6.41 OTHER EXPENSES
651 5023990 S12176 799987 1,034.54 AUTO STIR
Remit To
LABSOURCE, INC
97400 Eagle Way
Chicago, IL 60678 -9740 L abSource
PH: 800 545 -8823 •FAX: 630- 343 -1701 FEiN #36- 3631684
Invoice 799987
Date 06/15/2010
PO# S12176
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
Custdrnzr# T __S h i IY Via r EUCt_ i
CAR571 UPS Ground Commercial Origin NET 30 DAYS
Purchase Order Salesperson Order Date, Sales Order
S12176 AF 06/02/2010 681529
Quantity
Line UOM Catalog Description Price Extended
Ord Ship BO
1 1 1 0 EA 13- 642 -234 ORION DO AUTO STIR PROBE $1,034,541 $1,034.54
Subtotal $1,034.54
Shipping Handling $6.41
Invoice Total $1,040:95
Page 1 of 1
VOUCHER 105733 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
799987 01- 7202 -05 $1,034.54
799987 01- 7202 -05 $6.41
Voucher Total $1,040.95
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1965)
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 6/30/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/30/2010 799987 $1,040.95
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