155246 01/10/2008 CITY OF CARMEL, INDIANA VENDOR: 194400 Page 1 of 1
ONE CIVIC SQUARE CHEM -AQUA, INC
CARMEL, INDIANA 46032 23261 NETWORK PLACE CHECK AMOUNT: $194.81
CHICAGO IL 60673 -1232 CHECK NUMBER: 155246
CHECK DATE: 1/10/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350400 473426 194.81 GROUNDS MAINTENANCE
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ORIGINAL
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INVOICE
We Treat Your Water Right' REORDERS CALL: 1 -800 -527 -9921 CHEMAO UA
CORRESPONDENCETO: 23261 NETWORK PLACE
P.O. BOX 152170 FAX 1- 972 438 -0634 CHICAGO. IL 60673 -1232
t 1RV►NC,TExns 7sals rvww.CHEMAOUA.com
SOLD TO: SHIPPED TO:
Electronic funds Transfer
(EFT)
CARMEL POLICE STATION
3 CIVIC SQ payments are encouraged
CARMEL POLICE STATION CARMEL IN
3 CIVIC SO 46032
CARMEL IN 46032 To enroll please call
1- 800 -52 7- 9919 -x0831
Cust. Acct. No. Invoice No. Invoice Date Terms Sales Rep Order No. Ship Date Customer F.O. No.
CB002439 473426 12 -18 -07 NET 10 DAYS 7C34 0710L 12 -17 -07
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 11.05 194.81
IN Tax 003512371 -001 -3 Federal Id #75- 2761907
CREN -AQUA, INC., ALL RETURNS, CLAIMS FOR ERRORS OR ADIUSTMENTS OF ANY RIND
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. SHIPPING P
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.
ti
Payee
Ghem —Auga Purchase Order No.
23261 Newtwork Place
Chicago, IL 60671-1239 Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/18/07 473426 monthly payment 194.81
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.
1 20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
C IN SUM OF
23261 Network Place
Chicago, IL 60673 -1232
194.81
ON ACCOUNT OF APPROPRIATION FOR
p olice general fund
Board Members
Polt or
DEPT. INVOICE NO. ACCT #/TITLE AMOUNT i hereby certify that the attached invoice(s), or
1110 473426 501 194.81 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
January 3, 2008
Signature
Acting Chief of Police
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund