167316 12/23/2008 CITY OF CARMEL, INDIANA VENDOR: 355990 Page 1 of 1
0 ONE CIVIC SQUARE ENVIRONMENTAL LABORATORIES INC CHECK AMOUNT: $850.00
CARMEL, INDIANA 46032 635 GREEN ROAD
PO BOX 968 CHECK NUMBER: 167316
MADISON IN 47250
CHECK DATE: 12/23/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AM DESCRIPTION
601 5023990 W08548 20088314 850.00 TESTING
I
i
I
nvironmental
L aboratories, ne.
Invoice No. 20088314 635 GREEN ROAD, PO BOX 968
MADISON, IN 47250
TEL: 812.273.6699 FAX: 812.273.5788
Billing Information: Order No 2008120166
ACCOUNTS PAYABLE P.O. No.
CARMEL UTILITIES Quote No.
3450 W. 131st STREET Invoice Date 12/08/2008
WESTFIELD IN 46074
Test Name Quantity List Price
HAA5 3.00 $210.00 630.00
STATE Forwarding Fee 1.00 $10.00 10.00
TOTAL THM 3.00 $70.00 210.00
W�
Page 1 Total Due 850.00
(Fold and Tear Here)
VOUCHER 083954 WARRANT ALLOWED
355990 IN SUM OF
"ENVIRONMENTAL LABORATORIF�S,_In
635 GREEN RD.
P.O. BOX 968 ®,Cl 2
MADISON, IN 47250
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
20088314 01- 6350 -03 $850.00
ICA
Voucher Total $850.00
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,
r
price per unit, etc.
Payee
355990
ENVIRONMENTAL LABORATORIES, INC. Purchase Order No.
635 GREEN RD. Terms
P.O. BOX 968 Due Date 12/16/2008
MADISON, IN 47250
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
12/16/2001 20088314 $850.00
t�
I hereby certify that the attached invoice(s), or bill(s) is (8re) true and
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
/17 /u e A,--
Date Officer