191606 11/10/2010 �.\Lf CITY OF CARMEL, INDIANA VENDOR: 361475 Page 1 of 1
ONE CIVIC SQUARE DAILY LABORATORIES CHECK AMOUNT: $120.00
CARMEL, INDIANA 46032 2200 W ALTORFER SUITE B
PEORIA IL 61615 CHECK NUMBER: 191606
CHECK DATE: 11/10/2010
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 4174 120.00 CONT SVS- TESTING -S PL
Daily Laboratories
Division of Mobilab, Inc. Invoice
2200 W. Altorfer Dr. Suite B Number: 4174
Peoria, IL 61615
(309) 691-4513 Date: October 21, 2010
Bill To Ship To:
Tara Washington
City of Carmel WWTP
9609 Hazel Dell Pkwy
Indianapolis, IN 46280
P.O. Number Terms Project
TARA 30 days
ti
Date Quantity Description rice Each Amount
10/18 1 Suitability test on deionized water 120,00 120-00
Total $120.00
VOUCHER 106515 WARRANT ALLOWED
`361475 IN SUM OF
DAILY LABORATORIES
PEORIA, IL 61615 -2-�20 0
S�B
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO [NV ACCT AMOUNT Audit Trail Code
4174 01- 7352 -05 $120.00
Voucher Total $120.00
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
361475
DAILY LABORATORIES Purchase Order No.
5120 BIG HOLLOW ROAD Terms
PEORIA, IL 61615 Due Date 11/3/2010
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/3/2010 4174 $120.00
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
V'—
Date Officer