174891 07/22/2009 CITY OF CARMEL, INDIANA VENDOR: 118000 Page 1 of 1
e 0 ONE CIVIC SQUARE HACH COMPANY
CARMEL, INDIANA 46032 2207 COLLECTIONS CENTER DRIVE CHECK AMOUNT: $818.45
CHICAGO IL 60693 CHECK NUMBER: 174891
CHECK DATE: 7/22/2009
DE PARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 W08786 6286830 818.45 SPECTROPHOTOM
,n
INVOICE NO 6286830 DATE: 1 06/1972009
ICI. JJI 111111111111111111111111111111111111111111111111111 PURCHASE w08786
o ORDER
L CARMEL UTILITIES NUMBER
D 3450 W 131st St ���111 Net 30 Days From Invoice Date
Westfield, IN 46074 -8267 I l{i TERMS
T United States t�
e FREIGHT
S Sort Seg: 599 Tray: 3 CARRIER
H CARMEL UTILITIES ACCOUNT 1 052653
3450W 131 ST ST REF O 308724841 -1 emit to:
P WESTFIELD, IN 46074 -8267 Hach Company
T United States 2207 Collections Center Dr
Chicago, IL 60693
Phone: (800) 227 -4224
These commodities are sold, packaged, marked, and labeled for destinations in the United States.: Exportation of these commodities may require special licensing, packaging, marking or labeling.
LN# PRODUCT DESCRIPTION ITEM NO. QUANTITY UNIT PRIC EXT. PRICE
1 MODULE, ILLUMINATOR REPLACEMENT 5905900 1 317.00 317.00
2 DISPLAY, LCD 240 X 320 DOTS FSTN 5164200 1 212.00 212.00
3 Repair Frt Chg /RPS- Surface (P) MC_FRR 1 26.95 26.95
4 Depot Labor Charge for HACH DEPOT_HACH 1.5 175.00 262.50
ORDER CONTACT: SUBTOTAL 818.45
V TAX 0.00
Notes: INVOICE TOTAL 818.45
SERVICE NOTES: SR:235706. Disassembled and clea inst ment. Replaced tocuh pad display and illuminator module. Reassembled unit
and tested for proper operation. See enclosed check -out sheet.
For order discrepancies or product exchanges please call 1 800 227 4224 to obtain Return Authorization.
FEDERAL TAX ID 42 0704420
Environmental a
Test Systems Other Brands
LVIAR.srH
A9cf3IFtNEY froM Ha
Hydrornat
800 -Fi48 -4381 800- 949 3756 800 -368 -2723 800 -677 -0067 800- 454 -0263
Fax:574- 264 -45LQ Nix:970- 461 -3921 Fax: 301.874 -8459 Fax: 994.3574 Fax: 970- 461 -3919
Prescribed by State Board of Accounts t 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
118000
HACH CHEMICAL CO. CORP Purchase Order No.
2207 Collections Center Dr. Terms
Chicago, IL 60693 Due Date 7/14/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
7/14/2009 6286830 $818.45
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
Date Officer
VOUCHER 0923101 VVARRANT ALLOWED
11'8000 IN SUM OF
HACH CHEMICAL CO. CORP
2�07 Collections Center Dr.
Chicago, IL 60693
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
t"
��1y 6286830 01- 6200 -03 $555.95
b
6286830 01-6360-04 $262.50
Voucher Total $818.45
Cost distribution ledger classification if
claim paid under vehicle highway fund