170341 04/01/2009 CITY OF CARMEL, INDIANA VENDOR: 194400 Page 1 of 1
`z ONE CIVIC SQUARE CHEM -AQUA, INC CHECK AMOUNT: $200.29
CARMEL, INDIANA 46032 23261 NETWORK PLACE
CHICAGO IL 60673 -1232 CHECK NUMBER: 170341
CHECK DATE: 4/1/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1110 4350100 543419 200.29 BUILDING REPAIRS MA
.59,.
y
ORIGINAL
C MAQUA INVOICE
We Treat Your Water Right' REORDERS CALL: 1- 800 -527 -9921 CHEMAOUA
CoaRHSPONDFN TO: 2326.1 NETWORK PLACE
P.O. BOX 152170 FAX 1 -972- 438 -0634 CHICAGO. IL 60673 -1232
1R!'1NG,TEXAS 75015 www.CHEMAOUA.com
SOLD TO: SHIPPED TO:
Electronic Funds Transfer
(EFT)
CARMEL POLICE STATION
CARMEL POLICE STATION 3 CIVIC SO payments are encouraged
CARMEL IN
3 CIVIC SQ 46032 To enroll please call
CARMEL IN 46032
1- 800 -52 7- 991.9 -x0831
Cust. Acct. No. Invoice No. Invoice Date Terms Sales Rep Order No. Ship Date Customer P.O. No.
CB002439 1 543419 1 03 -17 -09 NET 10 DAYS 1 7C34 0712C 03 -16 -09
Product Packaging Descrip Unit Price Oty Billed Amount
X005 1 WATER TRTMT PROD /OR SVC 200.29 1 EA 200.29
Merchandise State Tax Local Tax *Shipping Inv. Total Amount
200.29 200.29
IN Tax 003512371 -001 -3 Federal ld #75- 2761907
CHEM -AQUA, INC., ALL RETURNS, CLAIMS FOR ERRORS OR ADJUSTMENTS OF 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. DELVD_
Prescryzd by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
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
ChemAgua Purchase Order No.
23261 Network Place Terms
Chicago, IL 60673 -1232 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
3/ 17/09 543419 monthly payment 200.29
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.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
yf
ALLOWED 20
C hemAqua
IN SUM OF
23261 Network Place
Chicago, IL 60673 --1232
200.29
ON ACCOUNT OF APPROPRIATION FOR
police general fund
Board Members
PO# or INVOICE NO. ACCT /TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 543419 501 200.29 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
March 25 2009
A"_
Signature
('hi f off Po11c
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund