HomeMy WebLinkAbout194666 02/16/2011 CITY OF CARMEL, INDIANA VENDOR: 363758 Page 1 of 1
Q� ONE CIVIC SQUARE LABSOURCE CHECK AMOUNT: $87.50
CARMEL, INDIANA 46032 97400 EAGLE WAY
CHICAGO IL 60678 -9740 CHECK NUMBER: 194666
CHECK DATE: 2116/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 817399 87.50 OTHER EXPENSES
to a
Remit To �e
LABSOURCE, INC
97400 Eagle Way
Chicago, 8678 -9740 LabSource
PH: 800 -544 5 8823 •FAX: 830- 343 -1781 FEIN #36 3631684
Invoice 817399
Date 0/131/2011
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
Quantity
Line UOM Catalog Description Price Extended
Ord Shi BO
1` 1 1 0 _1_ CS 11- 890 -8D STERI -WRAP 124X241N 500 /CS $169.50 $0.00
2 10 --0 10 PK AP4004700 GL ASS FIBER FIL TER 47MM 10OPK $3 9.69 $0.00
3 1 0 1 �EA 13 -641 -928 INT ERNAL FILL SOLN 0.1M 50ML $51.50 $0.00
j 4 2 0 2 E 13 -6 -883 AMMONIA PH ADJUSTING ISA $81.41 $0.00
5 5 5 k 0 PK P22 272 Finntip 10ml, Bulk, Bagged, 100 /pk $17.50 $87.50
0 PK 13- 297 -200 POLYSEED CAPSULES 501PK $99.00 $0.00
Pkg1- lZ22E4360340905681
Subtotal $87.50
Shipping Handling $0.00
Invoice Total $87.50
Page 1 of 1
VOUCHER 107096 WARRANT ALLOWED
363758 IN SUM OF
LABSOURCE
4186 ARBGR ID
,IL
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO I NV ACCT AMOUNT Audit Trail Code
817399 01- 7202 -05 $87.50
Voucher Total $57.50
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
ROMEOVILLE, IL 60446 Due Date 2/9/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
219/2011 817399 $87.50
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
Date Officer