191624 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 355990 Page 1 of 1
ONE CIVIC SQUARE ENVIRONMENTAL LABORATORIES INC
h O 635 GREEN ROAD CHECK AMOUNT: $190.00
CARMEL, INDIANA 46032
PO BOX 968 CHECK NUMBER: 191624
MADISON IN 47250
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 20106671 190.00 6350.03
nv ironmental
Invoice Laboratorie inc.
635 Green Road, PO Box 968, Madison, N 47250
Tel: 812.273.6699 Fax: 812.273.5788
Page 1 of 1
Bill To: Invoice ND.: 20106671
Accounts Payable Invoice Date: 10/20/2010
CARMEL UTILITIES Date Received: 09/28/2010
3450 W. 131st STREET Order No.: 2010090726
CARMEL, IN 46074 PO No.:
Item �.xesr Narrie d
C�aartth+ a �1l� t Cosh ��,hne Totl`
SOC Addt'I Monitoring EPA 5252 1 $180.00 $180.00
State Forwarding Fee 1 $10.00 $10.00
(Fold and Cut Here) Invoice Total: $190.00
VOUCHER 103172 WARRANT ALLOWED
355990 IN SUM OF
ENVIRONMENTAL LABORATORIES, If\
P.O. BOX 968
MADISON, IN 47250
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
20106671 01- 6350 -03 $190.00
Voucher Total $190.00
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
355990
ENVIRONMENTAL LABORATORIES, INC. Purchase Order No.
635 GREEN RD. Terms
P.O. BOX 968 Due Date 10/29/2010
MADISON, IN 47250
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/291201( 20106671 $190.00
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 O V"e r