174288 07/08/2009 CITY OF CARMEL, INDIANA VENDOR: 361475 Page 1 of 1
ONE CIVIC SQUARE DAILY LABORATORIES
CARI4IEL, INDIANA 46032 512D BIG HOLLOW ROAD CHECK AMOUNT: $120.00
y o„ zo PEORIA IL 61615 CHECK NUMBER: 174288
CHECK DATE: 7/812009
DEPARTMENT T ACCOUNT PO NUMBER INVOICE NUM A MOUN T DESCRIPTION
651 5023990 3382 120.00 OTHER EXPENSES
vary Laboratories 00ft �..:.r WMkL
Division of Mohilah, Inr_. I I I v I
2200 v'. Aiioi ler Dr. Suite 8
Number: 3382
Peoria, ii 616 I'D
(309) 691 -4513 Dale: june 18 2009
Bui i u: Ship T
Tara Rubush
I City of Carmel WWTP I I
9609 Hazel Dell Pk j
ulu,ana p us, ur -rvc.w
I
P.O. Number I Terms P roject
i8i 8 3 u8y5
Date Quan tity I Description price Each Amount I
7 Sultabiuiy lesi w uisfilleu_ walei
ILU.UU ILU.UU
Total $120.00
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
361475
DAILY LABORATORIES Purchase Order No.�
5120 BIG HOLLOW ROAD Terms
PEORIA, IL 61615 Due Date 7/1/2009
1 nvoice I nvoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/1/2009 3382 $120.00
ti
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 ffice
VOUCHER 095962 WARRANT ALLOWED
3151475 IN SUM OF
DAILY LABORATORIES
5120 BIG HOLLOW ROAD
PEORIA, IL 61615
Carmel Wastewater Utility
i f ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
3382 01- 7352 -05 $120.00
Voucher Total $120.00
Cost distribution ledger classification if
claim paid under vehicle highway fund