170440 04/01/2009 CITY OF CARMEL, INDIANA VENDOR: 00352337 Page 1 of 1
0 ONE CIVIC SQUARE INDUSTRIAL CHEM LABS SVCS CHECK AMOUNT: $241.46
CARMEL, INDIANA 46032 55 -G BROOK AVENUE
DEER PARK NY 11729 CHECK NUMBER: 170440
CHECK DATE: 4/1/2009
DEPARTMEN ACC OUNT PO NUMBER INVOI NUMBER AMOUNT DES
r-551 5023990 50067 241.46 OTHER EXPENSES
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INDUSTRIAL CHEM. LABS
SERVICES INC.
55 G BROOK AVE
DEER PARK, NY 11729 -7200 DATE INVOICE
PH: 800-827-0869 3/4/2009 50067
BILL TO: SHIP TO:
CITY OF CARMEL SAME
ACCOUNTS PAYABLE
9609 HAZEL DELL PARKWAY- OFFICE
INDIANAPOLIS, IN 46280 -2935
P.O. TERMS REP SHIP VIA Ref
JEFF COOPER Net 30 CH 3/4/2009 UPS 41
50 LIFT STATION D... LIFT STATION DEGREASER 3.89 194.50
S H SHIPPING HANDLING 46.96 46.96
$241.46
VISA/ MASTERCARD ACCEPTED FOR EASY PAYMENT. Payments/Credits
$0.00
ALL SALES ARE FINAL
Balance Due $241.46
Phone Fax #'s Web Site
800 827 -0869 631- 274 -3064 or 631- 254 -1597 www.chemlabs.info
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
352337
INDUSTRIAL CHEM LABS SVCS Purchase Order No.
55 -G Brook Avenue Terms
Deer Park, NY 11729 Due Date 3/25/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
3/25/2009 50067 $241.46
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= 1 1= 10 =1.6
Date Officer
✓OUCHER 095362 WARRANT ALLOWED
352337 IN SUM OF
NDUSTRIAL CHEM LABS SVCS
55 -G Brook Avenue
Deer Park, NY 11729
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
DO INV ACCT AMOUNT Audit Trail Code
50067 01- 7202 -06 $241.46
Voucher Total $241.46
:,ost distribution ledger classification if
-laim paid under vehicle highway fund