HomeMy WebLinkAbout204745 12/20/2011 CITY OF CARMEL, INDIANA VENDOR: 194400 Page 1 of 1
j ONE CIVIC SQUARE CHEM -AQUA, INC CHECK AMOUNT: $200.29
CARMEL INDIANA 46032
23261 NETWORK PLACE
CHICAGO IL 60673 -1232 CHECK NUMBER: 204745
CHECK DATE: 12/20/2011
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350100 576734 200.29 BUILDING REPAIRS MA
INVOICE Page of
p ��J ORIGINAL COPY e mittance °Address
V REORDERS CAUL 1 -800- 527 -9921. CHEMAQUA
We Treat Your Water Right* 23261 NETWORK PLACE
CORRESPONDENCE TO FAX 1- 972 -438 -0634 CHICAGO, IL 60673 -1232
PO BOX 152170 WWW.CHEMAQUA.COM
IRVING TX 75015
J..a. h1p; 1 0, To Pa y FT or
S
a b E
CARMEL POLICE STATION CARMEL POLICE STATION Direct Debit, Email
3 CIVIC SQ 3 CIVIC SQ
CARMEL IN 46032 CARMEL IN 46032 eac.credit @nch.com
or call
1- 800 -527 -9919 X0541
*_,.t. „Cuskomer_NO 8r11ingDate ,i..,,',., Terms Due!Date......': ShlpDate Sales_Order;
308405 15 -DEC -11 10 NET 25 -DEC -11 5 8203 1
C' `_._InvotceNo n �Purcfi'ase Orde;No :1 Sales Re No Sa1esRep: Name`,
576734 USCA704 COURTRIGHT, Mr, DAVID A
Product, t "Ordered'. W Description, y I Packagio g Bdlr d.. z,Uilit Amount
12015268 1 WATER TREATMENT PROGRAM EA 1.00 200.29 200.29
JMerchandtse State Tax Local Tax Shipping Split Inv; No Currency Total Amount
s
200.29 0.00 1 0.00 0.00 USD 200.29
IN Ta ID 010 1073755 001 0 Federal ID 7 2761907
CH ISM -AQUA, INC.. ALL RETURNS CLAIMS FOR ERRORS, OR ADJUSTMENTS OP 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. DESTINATION
VOUCHER NO. WARRANT NO.
Chem -Aqua ALLOWED 20
IN SUM OF
23261 Network Place
Chicago, I L 60673 -1232
$200.
ON ACCOUNT OF APPROPRIATION FOR
Carmel Police Department
PO# Dept. INVOICE NO, ACCT #/TITLE AMOUNT Board Members
1110 I 576734 43- 501.00 I $200.29 I hereby certify that the attached invoice(s), or
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
Mondpy, December 19, 2011
Chief of Police
Title
Cost distribution ledger classification if
claim paid motor 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 service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12/15/11 576734 monthly payment $200.29
1 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