173821 06/24/2009 CITY OF CARMEL, INDIANA VENDOR: 097251 Page 1 of 1
ONE CIVIC SQUARE FISHER SCIENTIFIC
CARMEL, INDIANA 46032 AC CT 440371 -001
CHECK AMOUNT: $38.39
13551 COLLECTIONS CENTER DRIVE
CHECK NUMBER: 173821
CHICAGO IL 60693
CHECK DATE: 6/24/2009
DEPARTMENT ACCOUNT P O N UMBER INVOIC NUM AMOUNT DESCRIPTION
651 5023990 6265492 38.39 OTHER EXPENSES
REMIT TO: INQUIRE AT: (800) 766 -7000 D- U- N -S -00- 432 -1519
ACCT# 440371 -001 4500 TURNBERRY DRIVE FEIN 23- 2942737
OFisher Sdentific 13551 COLLECTIONS CTR DR HANOVER PARK IL ORIGINAL INVOICE
Pert of Thermo Fisher Scientific CHICAGO IL 60133
60693 PLEASE REFER THIS INVOICE
NUMBER ON YOUR REMITTANCE
CUSTOMER PURCHASE ORDER NUMBER RELEASE NUMBER INV. DATE 6265492
511706 06/11/2009
ORDER NO. ACCOUNT NO. CSO F.O.B. ORDER ENTRY DATE PAGE DUPLICATE
B91348330 440371 -001 CHI SHIPPING POINT 05/14/2009 1
SOLD TO: SHIP TO: INVOICE TYPE:
NOR FON CON
ACCOUNTS PAYABLE TARA RUBUSH
CARMEL UTILITIES CITY OF CARMEL
nns[sn
STE 110 WASTEWATER TREATMENT PLT PARTIAL El
760 3RD SW AVE 9609 HAZEL DELL PKWY DUE: 07/11/2009 SHIPMENT
CARMEL IN 46032 -7612 INDIANAPOLIS IN 46280 -2935 TERMS: NET 30 DAYS FROM INVOICE DATE.
PAYABLE IN U.S. CURRENCY.
Visit: www•fishersci.com
DESCRIPTION CATALOG QUANTITY UNIT PRICE AMOUNT
NUMBER SHIPPED
CALLER -TARA RUBUSH
PHONE- 317 -571 -2634
SHIPMENT NBR: 003 FROM: MWD ON 06/11/2009
HG SUPPRESSANT LIQUID 475ML 17 976 6 1 EA 38.39 38.39
TOTAL INVOICE AMOUNT 38.39
FOR YOUR PROTECTION, OUR COMPANY DOE NOT ACCEPT CREDIT CAID NUMBERS VIA FAK OR EMAIL
FOR YOUR REFERENCE, AN ASTERISK HAS IEEN PLACED BY THOSE I EMS FOR WHICH MS S(S) WILL BE P OVIDED
UNDER SEPARATE COVER. CONTACT YOUR C STOMER SERVICE REPRES NTATIVE IF ADDIT ONAL INFORMATI N NEEDED.
PLEASE USE REMIT TO ADDRESS ABOVE AND I CLUDE DEPT. NBR.
SEE REVERSE SIDE FOR ADDITIONAL TERMS AND CONDITIONS
PAST DUE BALANCES ARE SUBJECT TO A FINANCE CHARGE. THIS SHIPMENT WAS DELIVERED IN PERFECT CONDITION
AND SIGNED FOR BY THE TRANSPORTATION COMPANY. CONSIGNORS RESPONSIBILITY CEASES UPON DELIVERY OF
GOODS TO CARRIER. DO NOT ACCEPT SHIPMENT SHOWING EVIDENCE OF DAMAGE OR SHORTAGE UNTIL AGENT OF
CARRIER ENDORSES NOTATION TO THIS EFFECT ON FACE OF TRANSPORTATION RECEIPT. WITHOUT THIS
DOCUMENTARY EVIDENCE CLAIM CANNOT BE FILED. SELLER CERTIFIES THAT ALL GOODS (OR SERVICES) COVERED
BY THIS INVOICE WERE PRODUCED IN COMPLIANCE WITH ALL APPLICABLE REQUIREMENTS OF SECTIONS 6, 7, AND 12
OF THE FAIR LABOR STANDARDS ACTS OF 1938, AS AMENDED, AND OF THE REGULATIONS AND ORDERS OF THE
UNITED STATES DEPARTMENT OF LABOR ISSUED UNDER SECTION 14 THEREOF.
NO CREDIT WILL BE ALLOWED FOR MERCHANDISE RETURNED WITHOUT PRIOR AUTHORIZATION.
THE PRICES SHOWN ON THIS INVOICE ARE NET OF DISCOUNTS PROVIDED AT THE TIME OF PURCHASE. SOME
PRODUCTS MAY BE SUBJECT TO ADDITIONAL DISCOUNTS AGREED UPON BETWEEN THE PARTIES. SEE REVERSE SIDE
FOR DISCOUNT OR PRICE REDUCTION DISCLOSURE REQUIREMENTS.
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VOUCHER 095857 WARRANT ALLOWED
97251 IN SUM OF
FISHER SCIENTIFIC 440371
DEPT 440371
13551 COLLECTIONS CTR DR
CHICAGO, IL 60693
Carmel Wastewater Utility
ON ACCOUNT OF APPROPR_I_ATION FOR
�4
Board members
PO INV ACCT AMOUNT Audit Trail Code
6265492 01- 7202 -05 $38.39
Voucher Total $38.39
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
97251
FISHER SCIENTIFIC 440371 Purchase Order No.
DEPT 440371 Terms
13551 COLLECTIONS CTR DR Due Date 6/17/2009
CHICAGO, IL 60693
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
6/17/2009 6265492 $38.39
e
hereby certify that the attached invoice(s), or bill(s) is (are) true and
:orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer