199557 07/20/2011 CITY OF CARMEL, INDIANA VENDOR: 358238 Page 1 of 1
ONE CIVIC SQUARE LABCHEM INC
CARMEL, INDIANA 46032 200 WILLIAM PITT WAY CHECK AMOUNT: $191.1fi
PITTSBURGH PA 15238 CHECK NUMBER: 199557
CHECK DATE: 7/20/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 767376 191.16 MATERIALS SUPPLIES
INVOICE
LT LabChem Inc Invoice 11) :767376
200 William Pitt Way Sales Order ID 771210
Pittsburgh, PA 15238 Inv oice Date 6/28/2011
Phone: (412) 826 5230 Ship Date 6/28/2011 12:08:00 PM
Fax: (412) 826 5234 Customer PO 11) S 12588
Page Number 1 of 1
AR Terms: Due Date: Amount Due:
Net 30 Days 7/28/2011 $191.16
sill To 1265 Ship To
CARMEL WWTP CARMEL WWTP
ATTN: ACCOUNTS PAYABL 9609 HAZEL DELL PKWY
760 3RD AVE SOUTHWEST INDIANAPOLIS, IN 46280 -2935
SUITE 110 USA
CARMEL, IN 46032
USA
Order Date: 6/28/2011 11:04:32 AM FOR: Pittsburgh, PA
Packing Slip: 367894 Currency Type USii
Ship Method: FedEx Ground Service
Line Nbr Item ID Item Name Unit of Shipped Unit Price Sales Tax Extra Extended
Cost Item ID Measure Qty Charges Price
1 LC 148451 GLUCOSE- GLUTAMIC ACID EA 4.0000 $30.0000 $0.0000 $120.00
R/O Qty: 0.0000
Lot Number Ex iraa Date Lot Trans Oty
A105 -22 05/11/2013 4
Line Item Total: $120.00
2 LC226002 SILVER NITRATE, 0.0141N (0.0141M) EA 2.0000 $31.2000 $0.0000 $62.40
R/O Qty; 0.0000
Lot Number Expiration Date Lot Trans Q�
A073 -17 09/15/2012 2
Line Item Total: $62.40
Subtotal: $182.40
Sales Tax: $0.00
Tracking Numbers:
Shipping Charges: $8.76
015396465077599 Total: $191.16
Form #34.01 04/11/2011 See "%v vw.tabchem.net" for C of A and MSDS information All Products Made In USA
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
358238
LABCHEM INC Purchase Order No.
200 WILLIAM PITT WAY Terms
PITTSBURGH, PA 15238 Due Date 7/7/2011
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/7/2011 767376 $191.16
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
VOUCHER 115426 WARRANT ALLOWED
358238 IN SUM OF
LABCHEM INC
200 WILLIAM PITT WAY
PITTSBURGH, PA 15238
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
767376 01- 7202 -05 $191.16
Voucher Total $191.16
Cost distribution ledger classification if
claim paid under vehicle highway fund