161308 07/11/2008 CITY OF CARMEL, INDIANA VENDOR: 194400 Page 1 of 1
L ONE CIVIC SQUARE CHEM -AQUA, INC CHECK AMOUNT: $183.76
CARMEL, INDIANA 46032 23261 NETWORK PLACE
CHICAGO IL 60673 -1232 CHECK NUMBER: 161308
CHECK DATE: 7/11/2008
DEPARTMENT ACCOUNT PO NU INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350100 5020741 183.76 BUILDING REPAIRS MA
ORxGINAL
fits a t; k� resE
CFfi111.AQUA INVOICE
We Treat Your Water Right" REORDERS CALL: 1- 800 -527 -9921 CHEMAOUA
CORRESPONDENCE TO: 23261 NETWORK PLACE
P0. BOX 152170 FAX 1- 972 438 -0634 CHICAGO. IL 60673 -1232
1RVING,TEXAS 75015
www.CHEMAOUA.corn
SOLD TO: SHIPPED TO:
1 Electronic Funds Transfer
(EFT)
CARMEL POLICE STATION
CARMEL POLICE STATION 3 CIVIC SO payments are encouraged
CARMEL IN
3 CIVIC SO 46032
CARMEL IN 46032 To enroll please call
1- 800 -52 7- 991.9- x0831.
trust. Acct. No. I Invoice No. ?nvoice Date Terms Sales Rep I Order No. I Ship Date I Customer P.O. No.
CBn02439 502074 .06 -19 -08 NET 1n JAYS 7034 0711F 06 -18 -09 1
Product Packaging Description Unit Price Qty Billed Amount
X005 1 WATER TRTMT PROD /OR SVC 183.76 1 EA 183.76
Merchandise State Tax Locai Tax *Shipping Inv. Cotal Amount
183.76 1 183.76
IN Tax 003512371 -001 -3 Federal Id #75- 2761907
CHEM -AQUA, INC., ALL RETURNS, CLAIMS FOR ERRORS OR ADJUSTMENTS OF ANY KIND
MUST BE MADE WITHIN 15 DAYS AFTER RECEIPT OP GOODS. MERCHANDISE NOT ACCEPTED FOR CREDIT WITHOUT OUR PRIOR
WRITTEN cowm T. DISTRIBUTION SERVICES INCLUDE SHIPPING HANDLING CHARGES F.O.B. DELW
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
ChemA'ua
4 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))
6/19/08 502074 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.
i ALLOWED 20
Che►nAqua IN SUM OF
23261 Network Place
Chicago, IL 60673 -1232
183.76
ON ACCOUNT OF APPROPRIATION FOR
police genera fnd
Board Members
PO# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. 1 hereby certify that the attached invoice(s), or
1110 502074 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
June 27 20 08
Signature
Chief of POlice
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund