172872 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 362241 Page 1 of 1
ONE CIVIC SQUARE HORIBA INTERNATIONAL CORP CHECK AMOUNT: $93.94
CARMEL, INDIANA 46032 LOCKBOX 776013
6013 SOLUTIONS CENTER CHECK NUMBER: 172872
CHICAGO IL 60677 -6000
CHECK DATE: 5/2712009
DEP ARTMENT ACCOU PO NUM INVOICE NUMBER AM OUNT DESCR
1110 4239099 211841 93.94 OTHER MISCELLANOUS
PLEASE I°IORIBA JOBIN YVON INC Horiba International Corporation 1
Lockbox# 776013
3880 PARK A�YENUE
F OMMAJOB N YVON 6013 Solutions Center n[c /ZnlA4
EDISON, N.J. "08820.3012 USA Chicago 60677 -6000
ISO 9001:2000 PHONE: 732. 494.8880
ACCT- FAX: 7321549.3791 Wire information:./
Horiba International Corporation
a Union Bank of California
1980 Saturn Street
Monterey Park, CA 91755 A7p79 -,A
ABA 1 22000496 71 IRAf Ri
CARMEL POLICE DEPT, CARMEL ,POLICE DEPT..
3 CIVIC SQUARE 3 CIVIC SQUARE
ATTN. JOHN ELLIOTT ATTN. JOHN ELLIOTT
CARMEL IN 46032 CARMEL IN 46033
Tax ID:
Tax Cert: 003120155 002 0 r SPECIAL INSTRUCTIONS
CUSTOMER P.O. NO;
FEDEX FP &A
0/14/09 `ELLIOTT;,' FOR ORIGIN, PREPAY AND ADD' 2105,.50120.200
LINE NO. QuANTITY
EXTENDEDORICIE TAX
SHIP DATE DESCRIPTION ITEM NUMBER SHIP/BOICANCEL UNIT PRICE
1.000
50ML MEDIUM VISCOSITY POLYCAST .IE1804 o EA'• 4.000 21.0000• 84.00. "Y
05/14/09 M
POLYVINYLSILOXANE _EA
2.000 1
Packing Handling' PACKING AND HANDLIN "u' EA 1.000 5.0000 5.00• N
05/14/09
EA
3.0.00
Freight, FREIGHT EA 1.000. 4.9400 4.94 N
TERM�" NET DUE :OSI14 /09 v
Net '30 days. 05/30/09 7.000 93.94
SEE TERMS AND CONDITIONS OF SALE ON BACK Cl1STOIIAER COPY
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
Hofiba International Corporation Purchase Order No.
Lockbox 4776013 Terms
6013 Solutions Center
Chicago, IL 60677 -6000 Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
211841 payment for lab supplies 93.94
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.
ALLOWED 20
H orAa International Corporation IN SUM OF
Lockbox #7776013
6013 Solutions Center
Chi ago, IL 60677 -6000
r
93.94
ON ACCOUNT OF APPROPRIATION FOR
p olice general fund
Board Members
PO# or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
1110 211841 390 -99 93.94 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
May 19 2009
kv;j,,,,1 I
Signature
Chief of Police
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund