156131 02/06/2008 -«A; CITY OF CARMEL, INDIANA VENDOR: 194400 Page 1 of 1
ONE CIVIC SQUARE CHEM- AQUA, INC
CARMEL, INDIANA 46032 23261 NETWORK PLACE CHECK AMOUNT: $183.76
CHICAGO IL 60673 -1232
CHECK NUMBER: 156131
CHECK DATE: 2/612008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350100 479181 183.76 BUILDING REPAIRS IY MA
I
I
s ORIGINAL .'err tn�� s 9
CKM 4UA INVOICE
We Treat Your Water Right REORDERS CALL: 1- 800 -527 -9921 CHEMAOUA
CORRESPONDENCE TO: 23261 NETWORK PLACE
P.O. BOX 152170 FAX 1- 972 438 -0634 CHICAGO. IL 60673 -1232
IRVING, TEXAS 75015
www.CHEMAOUA.com
SOLD TO: SHIPPED TO:
r Electronic Funds Transfer
(EFT)
CARMEL POLICE STATION
CARMEL POLICE STATION 3 CIVIC SO payments are encouraged
CARMEL IN
3 CIVIC SO 46032 To enroll please call
CARMEL IN 46032
1- 800 -52 7- 9919 -x0831
Cost. Acct. No. Invoice No. Invoice Date Terms Sales Rep Order No. Ship Date Customer P.O. No.
CB002439 479181 01 -21 -08 NET 10 DAYS 704 0711A 01 -18 -08
Product PackagingDescription 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
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 P.O.H. 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))
1121108 4791:91 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.
t
ALLOWED 20
�e
ChemAqua IN SUM OF
23261 Network Place
Chicago, IL 60673 -1232
1$3.76
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
Po# or INVOICE NO. ACCT #/TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 479181 501 1 83 7 6 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
JannarV 29 20 08
Signature
Chief of police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund