189879 09/14/2010 CITY OF CARMEL, INDIANA VENDOR: 363758 Page 1 of 9
t ONE CIVIC SQUARE LABSOURCE
CHECK AMOUNT: $951.79
97400 EAGLE WAY
CARMEL, INDIANA 46032
CHICAGO IL 60678 -9740 CHECK NUMBER: 189879
CHECK DATE: 9/14/2010
DEPARTMENT ACCOUNT PO NUM INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 805863 673.56 OTHER EXPENSES
651 5023990 805931 278.23 OTHER EXPENSES
i
Remit To
LABSOURCE, INC
97400 Eagle Way
Chicago, IL 60678 -9740 LabSource
PH: 800 -545 -8823 FAX: 630- 343 -1701 FEIN #36 3631684
Invoice 805931
Date 08/24/2010
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.
CAR571 UPS Ground Commercial Origin NET 30 DAYS
Purchase Order# Salesperson Order Date Sales Order# j
S12236 DC 08/06/2010 685817
Line Quantity UOM Catalog Description Price Extended
Ord Ship BO
1 1 1 0 EA 13- 302 32 DO PROBE MAIN KIT 115.00 $1 15.00
2 2 2 0 EA 13- 641 -883 AMMONIA PH ADJUSTING ISA $61.41 $122.82
Subtotal $237.82
Shipping Handling $40.41
Invoice Total F7 $278.23
AUG 3 2010
B
Page 1 of 1
Remit To
LABSOURCE, INC
97400 Eagle Way
Chicago, IL 60678 -9740 LabSoiurce
PH: 800 -545 -8823 •FAX: 630 343 -1701 FEfN #36- 36316$4
Invoice 3
Date 0812412010
O# 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
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 S BO
1 1 1 0 PK_ 21 -195 -3 P TIP 1 -5 ML NATURAL 250PK $41.66 _$41.66
O
2 1 0 1 EA 13 302 -32 D PR OBE MAINT KIT $115.0 $0.00
3 1 1 0 EA SB101 -500 BUFFE C_OLR R ED P 4.00 5 00M L 17.92 $17.92
4 3 3 0 EA_ SB107 -500 BU FFE R CLRD YEL PH 7.00 500ML $17 .41 $52.23
5 3 _3_ 0 EA SB115 -500 B UFFE R C OLRD BLUE PH 10 500ML $18. $54.
6 10 10 O T PK AP4 004700 GLASS FIBE FIL 47M 10 0PK T $39.6 mm $396.90
0 CS 13- 6 80 -63 A SW ABS 1200/CS $2 3.00_ $23.0
8 2 0 2 EA 13 -641 -883 AMMON PH ADJU ISA $61.41 $0.00
l 9 IA EA 07- 578 -3B DR INDICAT 8 MESH 5LB $45.52 $45.52
Subtotal $631.26
Shipping Handling $42.30
Invoice Total $673:56
P�
By
Page 1 of 1
VOUCHER 166158 WARRANT ALLOWED
363758 IN SUM OF
LABSOURCE 91YOO
t 1 86 7AREs 7R7DTUVE
II RQME0
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
805931 01- 7202 -05 $237.82
805931 01- 7202 -05 $40.41
805 01.7202. L7
Voucher Total
Cost distribution ledger classification if
claim paid under vehicle highway fund
Prescribed by State Board of Accounts City Form No. 201 (Rev 19951
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 9/8/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
9/8/2010 805931 $278.23
I hereby certify that the attached invoice(s), or bill(s) is (are) true an
correct and I have audited same in accordance with IC 5- 11 -10 -1.
Date fficer