160293 06/10/2008 a 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
'r on as CHICAGO IL 60673 -1232 CHECK NUMBER: 160293
A
t
CHECK DATE: 6/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER A DESCRIPTION
1110 4350100 497560 183.76 BUILDING REPAIRS MA
emiita
ORIGINAL Rnce �ci
CHRAQUA INVOICE
We Treat Your water Right REORDERS CALL: 1- 800 -527 -9921 CIIEMAOUA
CoRRESPONOENCETo: 23261 NETWORK PLACE
".0. BOX 152170 FAX 1 -972- 438 -0634 CHICAGO. IL 60673 -1232
IRVING, TEXAS 75015 www.CHEMAOUA.com
SOLD TO: SHIPPED TO:
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 -527- 9919 -x0831
Cust. Acct. No. Invoice No. Invoice Date Terms Sales Rep Order No. Ship Date Customer P.O. No.
CB002439 497560 05 -20 -08 NET 10 DAYS 7C34 0711E 105 -19 -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 *Shippin- Inv. Total 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 OF GOODS. MERCHANDISE NOT ACCEPTED FOR CREDIT WITHOUT OUR PRIOR
WRITTEN CONSENT. *DISTRIBUTION SERVICES INCLUDE SHIPPING HANDLING CHARGES F.O.B. DELVD.
Prescribed by Stale Board of Acc, nls City Form No. 201 (Rev. 1995)
F 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
Chem Aqua Purchase Order No.
23261 Network Pl "ace Terms
Chicago, IL 60673 1:232 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
5/20/08 497560 monthly 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
Che, Aqua IN SUM OF
23261 Network Palce
Chicago, IL 60673 -1232
183.76
ON ACCOUNT OF APPROPRIATION FOR
police genrea lfund
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 497560 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
May 29 20 08
717441-
Signature
Chief of P01ice
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund