162292 08/07/2008 CITY OF CARMEL, INDIANA VENDOR: 194400 Page 1 of 1
ONE CIVIC SQUARE CHEM -AQUA, INC CHECK AMOUNT: $183.76
CARMEL, INDIANA 46032 23261 NETWORK PLACE
CHICAGO IL 60673 -1232 CHECK NUMBER: 162292
1 CHECK DATE: 817/2008
DEPARTM ACCOUN PO NU MBER I NUMB AMOUNT DESCRIPTION W
'1120 4350100 506905 183.76 BUILDING REPAIRS MA
ORIGINAL
CKM.AgUiA. INVOICE
We Treat Your water Right' REORDERS CALL: 1- 800 -527 -9921 CHEMAOUA
CORRESPONDENCE'ro: 23261 NETWORK PLACE
P.O. BOX 152170 FAX 1 -972 -438 -0634 CHICAGO. IL 60673 -1232
IRVING, TEXAS 75015 www.CI-IEMAOUA.com
SOLD TO: SHIPPED TO:
Electronic Funds Transfer
(EFT)
CARMEL POLICE STATION
CARMEL POLICE STATION 3 CIVIC SQ payments are encouraged
CARMEL IN
3 CIVIC SO 46032
CARMEL IN 46032 To enroll please call
1 -800- 527 9919 -x0831
Cost. Acct. No. Invoice No. Invoice Date Terms Sales Rep Order No. Ship Date Customer P.O. No.
CB002439 506905 07 -21 -08 NET 10 DAYS 704 0711G 07 -18 -08
Product Packaging Description Unit Price Qty Billed Amount
X005 1 WATER TRTMT PROD /OR SVC 183.76 1 EA 183.76
Merchandise State Tax Local Tax *Shipping Inv. Total Amount
183.76 183.76
IN Tax 003512371 -001 -3 Federal Id #75- 2761907
CHEN -AQUA, INC., ALL RETURNS, CLAIMS FOR ERRORS OR ADJUSTMENTS OF ANY KIND
MUST BE MADE WITHIN 15 DAYS AFTER RECEIPT OF GOODS, MERCHANDISE NOT ACCEPTED FOR CREDIT WITHOUT OUR PRIOR
WRITTEN CONSENT. "DISTRIBUTION SERVICES INCLUDE SHIPPING HANDLING CHARGES F.O.B. DELVD.
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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
ChemAqua Purchase Order No.
23261 Network Place Terms
Chicago, IL 60673 -1232 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
7/21/08 506905 monthly payment 183.76
Total
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.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
ChemAqua IN SUM OF
23261 Network Place
Chicago, IL 60673 -1232
183.76
ON ACCOUNT OF APPROPRIATION FOR
police genera lfund
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 506905 501 183.76 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
July 29 20 08
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund