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201446 09/13/2011 CITY OF CARMEL, INDIANA VENDOR: 00353237 Page 1 of 1 ONE CIVIC SQUARE TESTAMERICA INC ra CARMEL, INDIANA 46032 PO BOX 122314 DEPT 2314 CHECK AMOUNT: $119.70 DALLAS TX 75312 -2314 CHECK NUMBER: 201446 CHECK DATE: 9/13/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 21020581 119.70 OTHER EXPENSES page 1 of 3 Tx SUPPZ.Y BUSINESS ACCOUNT �AGGyC3l�WTSIPN�ARV r 603'3012 -U© p8 d F Maw Previous Balance 710.79 Closing Date 08/21/11 Payments 241.65 Next Closing Date 09/20/11 CARMEL STREET DEPT Credits 13.99 Payment Due Date 09/15/11 CINDY Purchases 56.95 3400 W 131ST ST Debits 0.00 Current Due 42. 96 CARMEL, IN 46074 -6267 FINANCE CHARGES 0.00 Past Due Amount 469.14 Credit Line 1,700 Late Fees 0.00 Minimum Payment Due 512.10 Credit Available 1,187 New Balance 512.10 CURRENT ACTIVITY Transaction LQCat ���f Amount ate Dascnptlon �f JUL 26 GOODS AND SERVICES WESTFIELD IN 40.97 JUL 28 GOODS AND SERVICES WESTFIELD IN CREDIT 13.99 -J/ AUG 15= GOODS AND SERVICES WE-S•TFIELD .-IN _15.98 TOTAL 6035301200074803 $42.96 PAYMENTS, CREDITS, FEES, and ADJUSTMENTS JUL 21 PAYMENT REF P9194006B09XK3RYR 241.65 Did you overlook your payment to us? If so, please send the amount due today. If payment is in the mail thank you! FINANCE CHARGE SUMMARY Current Billing Period Previous Billing Period Balance Daily Days in ANNUAL Balance Daily Days in ANNUAL Subject to Periodic Billing PERCENTAGE subject to Periodic &Il PERCENTAGE Finance Charge Rate Period RATE Finance Charge Rate Period RATE REGULAR REVOLVE CREDIT PLAN 0.00 00000 51 0.00 0.00 00000 31 0.0o This A ccouritissuedby, Cjtibank_(E outh;r)akota). NA CUSTOMER SERVICE 1- 800 559 -5232 _FAX NUMBER 1 -801_- 779 -7425 Notify Us in Case of Errors or Questions About Your Sill Copy Fee: On any matter unrelated to a billing error or disputed purchase, we charge a $5.00 fee for each duplicate statement for a billing period that If you think your billing statement is wrong, or if you need more information is more than 3 months prior to your request. We add this fee to your regular about a transaction on your billing statement, write to us (on a separate revolve credit plan balance. sheet) as soon as possible at the billing error address on the front of your statement. We must hear from you in writing no later than 60 days after we Payment Options Other Than Regular Mail: sent you the first statement on which the error or problem appeared. In your letter, give us the following information: Pay by Phone. You may make your payment by phone by using the Pay by Phone Service. You will be charged $14.95 to use this payment service. Your name and account number. Call by 5 p.m. Eastern time to have your payment credited as of that day. The dollar amount of the suspected error. If you call after that time, your payment will be credited as of the next day. Describe the error and explain, if you can, why you believe there is an We may process your payment electronically upon verification of your error. If you need more information, describe the item you are unsure identity. about. Send payment by courier or express mail to the Express Payments address: Customer Service Center, Dept CCS. 911, 4740121st St, Urbandale, Important Payment Instructions IA 50323. Payment must be received in proper form, at the proper address, by 5 p.m. local time in order to be credited as of that day. Crediting Payments: Payment must be received in proper form at our All payments received in proper form, at the proper address, after that processing facility by 5 p.m. local time there to be credited as of that day. A time will be credited as of the next day. payment received at the processing facility in proper form after that time will be credited as of the next day. Please allow 5 -7 days for payments by Report a Lost or Stolen Card Immediately: Customer Service is available regular mail to reach us. There may be a delay of up to 5 days in crediting a 24 hours a day, 7 days a week, payment sent by mail if it is not in proper form or is addressed to a location other than the address listed on the return envelope or on the front of the Your account is issued by Citibank (South Dakota), N.A. payment coupon, or, for courier or express mail payments, to the Express Payments Address set forth below. Proper Form: For a payment sent by mail or courier to be in proper form, you must: Enclose a valid check or money order, No cash, gift cards, or foreign currency please. Include your name and account number on the front of your check or money order. If you send an eligible check, you authorize us to complete your payment by electronic debit. If we do, the checking account will be debited in the amount on the check. We may do this as soon as the day we receive the check. Also, the check will be destroyed. Tractor Supply Co. Full Balance S902TV Rev. 01/11 TestAmerico INVOICE THE .LEADER IN ENVIRONMENTAL TESTING 4738 Gateway Circle Dayton, OH 45440 800 -572 -9839 Fax:937- 499 -1249 Invoice Number: 21020581 Invoice To: Remit Payment To: Cannel W WTP TestAmerica Laboratories, Inc. Teresa Lewis Dept 2314 9609 Hazel Dell Pkwy P.O. Box 122314 Indianapolis, IN 46280 Dallas, Tx 75312 -2314 TestAmerica EIN: 23- 2919996 1406871 For Billing Inquires please contact. 800 572 -9839 Client: Carmel WWTP Terms: See Below Invoice Date: 08/30/11 Client Contact: Teresa Lewis Lab Contact: Shelly A. Howard Project: Horton Fan Quarterly Analysis /Horton Fan Shelly .Howard @testamericainc.com PO Number: S -10403 Samples Received: 08/17/11 Samples Reported: 08/29/11 Workorder: DUH0770 Rush Rush Unit Extended Qty Analysis/Description Matrix TAT Charge Cost Cost I Cadmium Total EPA 200.7 Water NonPotable NA None $12.00 $12.00 1 Chromium Total EPA 200.7 Water NonPotable NA None $12.00 $12.00 1 Copper Total EPA 200.7 Water NonPotable NA None $12.00 $12.00 1 Cyanide, EPA 335.4 Water NonPotable NA None $30.00 $30.00 I Lead Total EPA 200.7 Water NonPotable NA None $12.00 $1100 1 Nickel Total EPA 200.7 Water NonPotable NA None $12.00 $12.00 1 pH Client Supplied Water NonPotable NA None $0.00 $0.00 1 Silver Total EPA 200.7 Water NonPotable NA None $1100 $12.00 1 Zinc Total EPA 200.7 Water NonPotable NA None $12.00 $12.00 Additional Items 1 Environmental Management Fee 5.00% $5.70 Invoice Total: $119.70 Any applicable rush charges are based on the actual tum- around -time met. Prices shown include all applicable discounts.TestAmerica's Standard Terms Conditions (Net 30 Days) apply to all work performed and invoiced unless superseded by a specific executed contract vehicle. Invoice: 21020581 Page 1 of I VOUCHER 115772 WARRANT ALLOWED 00353237 IN SUM OF TESTAMERICA INC PO BOX 99742 Chicago, IL 60690 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO INV ACCT AMOUNT Audit Trail Code 21020581 01- 7352 -05 $119.70 Voucher Total $119.70 Cost distribution ledger classification if claim paid under vehicle highway fund 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 of service rendered, by whom, rates per day, number of units, price per unit, etc. Payee 00353237 TESTAMERICA INC Purchase Order No. PO BOX 99742 Terms Chicago, IL 60690 Due Date 9/6/2011 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 9/6/2011 21020581 $119.70 hereby certify that the attached invoice(s), or bifl(s) is (are) true and correct and I have audited same in accordance with IC 5- 11- 10 -1.6 Date Officer