180026 12/08/2009 CITY OF CARMEL, INDIANA VENDOR: 00352978 Page 1 of 1
ONE CIVIC SQUARE CHEMSEARCH CHECK AMOUNT: $6fi8.70
CARMEL, INDIANA 46032 23261 NETWORK PLACE
CHICAGO IL 60673 -1232 CHECK NUMBER: 180026
CHECK DATE: 121812009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1205 4238900 681978 668.70 OTHER MAINT SUPPLIES
rA
11 0 ORIGINAL M1 Men a Tres ME
INVOICE
CWEMRCH. REORDERS CALL: 1 -800 -527 -9921 CHEMSEARCH
CORRESPONDENCE T O: 23261 NETWORK PLACE
P.O. Box 152170 FAX 1- 972 438 -0634 CHICAGO, IL 60673 -1232
IRVING, TEXAS 75015 www.CIIEMSEARCIt.com
SOLD TO: SHIPPED TO:
ACCOUNTS PAYABLE JEFF BARNES
Electronic Funds Transfer
e (EFT)
CITY OF CARMEL
CITY OF CARMEL 1 CIVIC SQUARE payments are encouraged
CARMEL IN
1 CIVIC SQUARE 46032' To enroll please call
CARMEL IN 46032
1- 800 -527- 9919 -xOS31
Cust. Acct. No. Invoice No. I Invoice Date Terms Sales Rep Order No. Ship Date Customer P.O. No.
60231584 681978 11-18-09 NET 10 DAYS 6388 0576@ 11 -17 -09
1Froduct Packaging Description
5068 1 DOZ SUPER CHEMSOLV AEROSOL 291.00 1 DOZ 291.00
5068 2 DOZ YIELD AEROSOL 160.00 2 DOZ 320.00
3H46 1 DOZ UPPER HAND (22 OZ TUBES) FREE 1DOZ N/C
D Q
a 7 2009
B
Merchandise State Tax =Local Tax *Shipping Inv. Total Amount
611.00 43.75 13.95 668.70
IN Tax 003512371 -001 -3 Federal Id #75- 0457200
CHRMSEARCH DIVISION OF NCR CORPORATION. ALL RETURNS, CLAIMS FOR ERRORS OR ADJUSTMENTS OF ANY RIND
MUST RE 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.
1
Prescribed 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
Chemsearch
Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
11/18/09 681978 Aerosols 668.70
Total $668.70
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
VOUCHER N%a7m_WAPRANT NO.
ALLOWED 20
Chemsearch IN SUM OF
23261 Network Place
Chicago, IL 60673 -1232
$668.70
ON ACCOUNT OF APPROPRIATION FOR
General Fund
1205 General Administration
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
1205 681978 389 $668.70 materials or services itemized thereon for
which charge is made were ordered and
received except
20
�Signattr
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund