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Home My WebLink About194258 02/03/2011 CITY OF CARMEL, INDIANA VENDOR: 363758 Page 1 of 1 ONE CIVIC SQUARE LABSOURCE i o CHECK AMOUNT: $561.50 CARMEL, INDIANA 46032 97400 EAGLE WAY CHICAGO IL 60678 -9740 CHECK NUMBER: 194258 CHECK DATE: 2/3/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 816702 561.50 MATERIALS SUPPLIES Remit To LABSOURCE, INC 97400 Eagle Way Chicago, IL 60678 -9740 La bS ource PH: 800 545 -8823 FAX: 630 -343 -1701 FEIN #36 3631684 Invoice 816702 Date 01/20/2011 PO# S12382 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 Destination NET 30 DAYS Purchase Order Salesperson Order'Date Sales Order'# S12382 DC 01/19/2011 696022 Line Quantity UOM Catalog Description Price Extended' Ord Slhip I BO 1 1 0 1 CS 11- 8 90 -8D STERI -WRAP 124X241N 500 1CS $169.50 $0.00 j 2 10 0 10 PK AP4 0_0470 0 GL ASS FIBE FI LTER 47MM 100 $39.69 $0.00 3 1 0 1 EA 13 -641 928 INTERNA FIL SOLN 0.1M 50 ML T $5 1.50 $0.0 j 4 2 0_ 2 EA 13 -641 -883 AMMON PH ADJUSTING ISA $61.41 $0.00 5. 2 2 0 PK M25 221 Cover Gl 22X22 #1 1oz /pk, 10 1cs $7.0 $1 4.00 6 1 5 5 PK P 22 -272 Fin 10m1, Bulk, Bagged, 100 /pk $17.50 87.50 7 1 0 1 PK 1 3- 297 -200 POL YSEED CAPSULES 50 /PK $99. $0.00 8 1 1 0 CS N852� Gloves, Nitrile, Blue, Powder -Free, Textured, $62.00 $62.00 Medium, 1 00/ k, 100 /c '9 4 4 0 GS N853 Gloves, Nitrile, Blue, Powder -Free, Textured, $62.00 $248.00 Larg 100 /0, 1000 /cs 10 4 4 0 EA� H10 -100 Buffer pH 4.0 500ml Red $12.50 $50.00 11 4 4 0 EA H1 -200 Buffer pH 7.00 500ml yellow $12.5 $50.00 12 4 4 0 EA H10 -300 Buffer pH 10.00 500ml Blue, 6 /cs $12.50 ��$50.00 Pkg 1 1Z22E4360340460429 Subtotal $561.50 Shipping Handling $0.00 Invoice Total $561.50 Page 1 of 1 VOUCHER 106986 WARRANT ALLOWED 363758 IN SUM OF LABSOURCE q -y -4flo 1� .)h E C.t C490 t 6©618' Carmel 'Wastewater Utility i ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 816702 01- 7202 -05 6561.50 Voucher Total $561.50 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 363758 LABSOURCE Purchase Order No. 1186 ARBOR DRIVE Terms ROMEOVUE, IL 60446 Due Date 1/31/2011 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 1/31/2011 816702 $561.50 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 12- e ,ti X12 Date Officer