192429 12/07/2010 CITY OF CARMEL, INDIANA VENDOR: 355990 Page 1 of 1
ONE CIVIC SQUARE ENVIRONMENTAL LABORATORIES INC CHECK AMOUNT: $790.00
CARMEL, INDIANA 46032 635 GREEN ROAD
PO BOX Sea CHECK NUMBER: 192429
MADISON IN 47250
CHECK DATE: 12!712010
DEPARTMENT ACCOUN PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 20107392 790.00 OTHER EXPENSES
nvirparnental
E
Invoice Labo ratorieS inc.
635 Green Road, PO Box 968, Wdison, IN 47250
Tel: 812.273.6699 Fax: 812.273.5788
Page 1 of I
Bill To: Invoice ND.: 20107392
Accounts Payable Invoice Date: 1 111 81201 0
CARMEL UTILITIES Date Received: 1012812010
3450 W. 131st STREET Order No.: 2010100624
CARMEL, IN 46074 PO No.:
Item /Test Nam e r° it
AL
HAAS 3 $190.00 $570.00
State Forwarding Fee 1 $10.00 $10.00
Total THM 3 $70.00 $210.00
(Fold and Cut Here) Invoice Total: $790.00
VOUCHER 103440 WARRANT ALLOWED
355990 IN SUM OF
ENVIRONMENTAL LABORATORIES, IN
635 GREEN RD.
P.O. BOX 968 WATER
M IN 47250 OPERAMONS
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
,I
PO INV ACCT AMOUNT Audit Trail Code
20107392 01- 6350 -03 $790.00
Voucher Total $790.00
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 11/30/2010
MADISON, IN 47250
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
11/30/201( 20107392 $790.00
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 Officer