191587 11/10/2010 CITY OF CARMEL, INDIANA VENDOR: 194400 Page 1 of 1
ONE CIVIC SQUARE CHEM -AQUA, INC
r CHECK AMOUNT: $200.29
CARMEL, INDIANA 46432 23281 NETWORK PLACE
G,�.. �o• CHICAGO IL 60673 -1232 CHECK NUMBER: 191587
CHECK DATE: 1111012010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350100 639117 200.29 BUILDING REPAIRS MA
"s'm
ORIGINAL
CFEII -AQUA INVOICE
woTreai Your WotorRight' REORDERS CALL: 1- 800 -527 -9921 CHEMAQUA
CORRESPO; DENCETO: 23261 NETWORK PLACE
P.O. BOX 152170 FAX -972- 438 -0634 CHICAGO, IL 60673-1232
IRV7NG,'I'R,XAS 75915
www.CHEMAQUA.com
SOLD TO: S1-IIPPED TO:
Electronic Funds Transfer
(EFT)
CARMEL POLICE STATION
CARMEL POLICE STATION 3 CIVIC SO payments are encouraged
CARMEL IN
3 CIVIC SQ 46032
CARMEL IN 46032 To enroll please call
1- 800 -527- 9919 -x0831
Cost. Acct. No. Invoice No. I Invoice Da te Terms Sales Re Ordce• No. Ship Date Customer P.O. No.
08002439 639117 1 1 0 -18 -10 NET 10 DADS 7C;34 0713J 10 -15 -10
Product Packaging rtion Unit Frice tv I3illcd Amount
X005 1 WATER TREATMENT PROGRAM 200.29 1EA 200.29
Merchandise State Tax Local Tax *Shi >inR Inv. Total Amount
200.29 1 1 200.29
IN Tax 0101073755 -001 -0 Federal Id# 75- 2761907
CMEM —AQUA, INC., ALL RETURNS, CLAIMS FOR ERRORS OR ADJUSTMENTS OF ANY KIND
MUST BE MADE WITHIN 15 DAYS AFTER RECEIPT OF GOODS. MMCHANDISE NOT ACCEPTED FOR CREDIT WITHOUT OUR PRIOR
WRITTEN CON$ENT. DISTRIBUTION SE'RVIC'ES INCLUDE SHIPPING 6 RANDLIirS CHARGES F.O.S. CELVD.
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Chemaqua Purchase Order No.
23261 Network Place
Terms
Chicago, IL 60673 -1232
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
10/18/10 639117 monthly payment 200.29
Total
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.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
Chemaqua
23261 Network Place IN SUM OF
Chicago, IL 60673 -1232
2 00.29
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
Mt or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 639117 501 200.29 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
November 3, 20 10
A d;j� b
Si
Chief of Po lice
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund