189415 08/31/2010 CITY OF CARMEL, INDIANA VENDOR: 363758 Page 1 of 1
ONE CIVIC SQUARE LABSOURCE
CARMEL, INDIANA 46032 97400 EAGLE WAY CHECK AMOUNT: $949.80
*t,+ CHICAGO IL 60678 -9740
CHECK NUMBER: 189415
CHECK DATE: 8/31/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 804482 535.94 72020.5
651 5023990 805192 206.12 OTHER EXPENSES
651 5023990 805260 207.74 OTHER EXPENSES
Remit To
LABSOURCE, INC
97400 Eagle Way
Chicago, IL 60678 -9740 LabSource PH. 800 -545 -8823 FAX: 630 343 -1701 FEIN #36 3631684
Invoice 805192
Date 08/1712010
PO# S12236
Bill To Ship To
City of Carmel City of Carmel
Tara Washington Tara Washington
Wastewater Lab Wastewater Lab
6909 Hazel Dell Pkwy 6909 Hazel Dell Pkwy
Indianapolis, IN 46280 Indianapolis, IN 46280
Customer Ship Via FOB. Terms,
CAR57 UPS Ground Commercial Origin NET 30 DAYS
Purchase Order Salesperson Order Date Sales Order
S12236 DC 08/06/2010 685817
Line Quantity Ord Ship BO DOM Catalog Description Price Extended
1 1 0 1 P K_ 21 -195 -3 PI PET TIP 1 -5 M NATURAL 250PK $41 .66 $0 .00
2 1 0 1 EA 13- 302 -32 DO PROB M AIN T KI T $11 $0.00
3 1 1 0 EA 2 3 77 -824 FINNP I 2 -10 $200.00 $200.00
4 2 0 2 EA 6_61 430 POLYS IN_O B -50 99.00 0.00
5 1 0 1 EA SB -50 B UFFER C OLRD RE D PH 4.00 50_0ML_ 17.92 $0.00
6. 3 0 3 EA S B107 500 BU FFER CLRD YE PH 7.00 500ML $17.41 $0.00
7 3 0� 3 EV SB115 -500 BUFFER COLRD BLU PH 10 500ML $18.01 $0.00
8 10 0 10 PK AP40047 GLA FIBER FILTER 4 10O $39 $0 .00
r vi �01 A SW ABS 1200 /CS $23.00 $0.00
2 0 2 EA 13 641 -883 AM MONIA PH ADJUSTING ISA $61.41 $0.00
1 0 1 EA 07 -3B DRIERITE INDICAT 8 MESH 5LB $45.52 $0.00
Subtotal $200.00
Shipping A Handling_ 512
Invoice Total $206:12
Page 1 of 1
Remit To
LABSOURCE, INC
97400 Eagle Way
Chicago, IL 60678 -9740 L abS PH: 800 -545 -8823 FAX: 630- 343 -1701 FEIN #36 3631684 o u
Invoice 805260
Date 08!9712010
PO# S12236
Bill To Ship To
City of Carmel City of Carmel
Tara Washington Tara Washington
Wastewater Lab Wastewater Lab
6909 Hazel Dell Pkwy 6909 Hazel Dell Pkwy
Indianapolis, IN 46280 Indianapolis, IN 46280
Customer Ship Via FOB Terms 1
CAR571 UPS Ground Commercial Origin NET 30 DAYS
Purchase Order Salesperson Order Date Sales Order
S12236 DC 08/06/2010 685817
Line rOr Shi BO UOM Catalog Description Price Extended
1 0 1 PK 21 -195 -3 PIPET T 1 -5 ML NATURAL 25OPK $41.66 $0.00
p 1 EA 13- 302 DO PR OBE MAIN KIT $115 $0.00
3 2 0 EA 6613 -43 PO LYSEED INOCULUM Bi -50 99.00 $1
L 4 1 0 1 EA SB101 -5 BUFFER CO RED PH 4. 00 500 $1 7.92 $0.0
5 3 0 3 �EA SB107 -500 B UFFER CLRD YEL PH 7.00 50 $17.41 $0.00
6
r 3 0 3 EA SB 115 -500 BUFF COLRD BLUE PH 10 500ML $18.01 $0.00
F 7 �1 0 10 PK A P4004700 _G LASS FIBER FILTER 47MM 10OPK $39.69 $0.00
8 1 0 1 CS 13- 680 -63 ALCOHOL SWABS 1 200 /CS $23.00 $0.00
0 2 EA 13 641 883 AMMONIA PH ADJUSTING ISA $61. $0.00
10 1 0 1 EA 07- 578 -313 DRIERITE INDICAT 8 MESH 5LB $45.52 $0.00
Subtotal $198.00
Shipping Handling $9.74
Invoice Total $207,74
Page 1 of 1
VOUCHER 106120 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
805192 01- 7202 -05 $200.00
805192 01- 7202 -05 $6.12
�c 260 v l.?�d2.a
13 'b
Voucher Total
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 8/27/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
8/2712010 805192 $206.12
I hereby certify that the attached invoice(s), or bill(s) is (are) true and
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer
Remit To
LABSOURCE, INC
97400 Eagle Way
Chicago, 60678 -9740 LabSource®
PH: 800 544 5 -8823 •FAX: 630 343 -1701 FE1N #36- 3631684
Invoice 804482
Date 0$!0912010
PO# 512236
Bill To Ship To
City of Carmel City of Carmel
Tara Washington Tara Washington
Wastewater Lab Wastewater Lab
6909 Hazel Dell Pkwy 6909 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
S12236 DC 08/06/2010 685817
Line Quantity UOM Catalog Description Price Extended
Ord Ship BO
1 1 0 1 PK 2 1 -19 -3 PIPET TIP 1 -5 ML NAT URAL 25 0PK $41.66 $0.00
2 1 0 1 EA 13- 302 32 DO P MAINT $11 $0.00
1 0 1 EA 21- 37 7 -824 FINNPI II 2 -10ML $0.00
4 2 0 2 EA 661 -4 POLYSEED IN BL -50 $99.0 $0
5 1 0 1 EA SB101 -500 B UF F ER COLRD RE PH 4 .00 50 0ML mm $17.92 $0.00
6 3 0 T 3 EA S_B107 -500 BUFFER CLRD YE PH 7.00 500ML 17.41 $0.00
7 3 0 3 EA S B115 500 BUFFER COLRD BLUE PH 10 500ML $18.01 $0.0
8 10 0 10 PK AP4004700 GLAS FIBER FILT 47MM 10OPK $39 .69 $0.00
7 1 1 0 CS N852 Gloves, Nitrile, Blue, Powder -Free, Textured, $62.00
Medium, 100 /pk, 1000 /cs
10 4 4 —0 CS N853 Gloves, Nitrile, Blue, Powder -Free, Textured, $6200 $248.00
Larg 100 /pk, 1000 1cs
L 12 1 0 1 CS 13- 680 -63 A LCOHOL SWABS 1200 /CS $23.00 $0.00
2 0 2 EA 13 -641 -883 A PH ADJUSTING ISA $61.41 $0.00
I. 13 1 __0 1 EA 07- 578 3B DRIE INDICAT 8 MES 5LB $45.5
14 10 10 IY 0_ PK P22 272 Finntip 10ml, Bulk, Bagged, 1001pk $17.50 $175.00
Pkg1- lZ22E4360306586484
Pkg 2- 1Z22E4360306586493
Pkg 3 1Z22E4360306586500 Subtotal $485.00
Pkg 4 lZ22E4360306586519 Shipping Handling $50.94
Pkg 5- lZ22E4360306586528
Pkg 6- 1Z22E4360306586537
Invoice Total $535.94
Page 1 of 1
VOUCHER 106057 WARRANT ALLOWED
363758 IN SUM OF
LABSOURCE
1186 ARBOR DRIVE
ROMEOVILLE, IL 60446
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO I NV ACCT AMOUNT Audit Trail Code
804482 01- 7202 -05 $485.00
804482 01- 7202 -05 $50.94
Voucher Total $535.94
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 1990
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
ROM EOVILLE, IL 60446 Due Date 8/24/2010
Invoice Invoice Description
Date Ndmber (or note attached invoice(s) or bill(s)) Amount
8/24/2010 804482 $535.94
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- 111- 10 -1.6
Date Officer