172853 05/27/2009 CITY OF CARMEL, INDIANA VENDOR: 118000 Page 1 of 1
ONE CIVIC SQUARE HACH COMPANY CHECK AMOUNT: $562.39
CARMEL, INDIANA 46032 2207 COLLECTIONS CENTER DRIVE
CHICAGO IL 60693 CHECK NUMBER: 172853
CHECK DATE: 5127/2009
DEPA AC COUNT PO NU MBER INVOICE N AMO UNT DESCRIPTION
601 5023990 6230908 562.39 OTHER EXPENSES
vL I"wl ."IN" VI Ilm. it gal
INVOICE NO 6230908 DATE: 1 05/13/2009
S li t- A!1. 11.. 1 Ill. I 1. I'M III loll Ili 1111111111111111111111111 PURCHASE Jaimie Lab 5
p ORDER
L CARMEL UTILITIES NUMBER
D 3450 W 131ST ST
WESTFIELD, IN 46074 -8267 TERMS Net 30 Days From Invoice Date
T United Statest(1
p V FREIGHT Prepay And Bill Customer
S Sort Seg: 525 Tray: 3
CARRIER RPS- RPS**FedEx- Ground
H CARMEL UTILITIES ACCOUNT 1 052653
1 3450 W 131ST ST REF. NQ 13086727 47 -1 Remit to:
P WESTFIELD, IN 46074 -8267 Hach Company
T United States 2207 Collections Center Dr
p Chicago, ;L
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
2 BOTTLE, WASH, NALGENE YELLOW PK/6 2928201 2 34.49 68.98
*TRACKING NUMBERS. 050316380248433
3 BOTTLE, WASH, NALGENE BLUE PK/6 2928202 2 34.49 68.98
*TRACKING NUMBERS: 050316380248433
4 HARDNESS 3 TEST SOLN 1000ML 42653 2 29.29 58.58
*TRACKING NUMBERS: 050316380248433
5 RGT 1, TISAB SOLN 473ML 2812811 4 26.75 107.00
*TRACKING NUMBERS: 050316380248433
6 FERROUS IRON RGT PP 25ML PK/100 103769 10 19.89 198.90
*TRACKING NUMBERS: 050316380248433
ORDER CONTACT: SUBTOTAL 502.44
JAIMIE FOREMAN FREIGHT CHARGES 59.95
317- 571 -2639 TAX 0.00
Notes: INVOICE TOTAL 562.39
For order discrepancies or product exchanges please call 1- 800 227 -4224 to obtain Return Authorization.
FEDERAL TAX ID 42- 0704420
Environmental GL�� LACHAT
v C� Environmental Radiometer
Test Systems )yjARST4
aeerpm nliswmmis fNSTRUMENTS anal tical
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AM Cm env.l aiic-'Y A CemyB.vb
800 548 -4381 800 454 -0263 800 949 -3766 800 454 -0263 800 454 -0263 800 368 -2723
Fax: 574-264-4533 Fax: 970-461-3919 Fax: 970 -461 -3921 Fax: 970-461-3919 Fax: 970-461-3919 Fax: 301-874-8459
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER
CITY OF C:ARMEL
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 5/18/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/18/2009 6230908 $562.39
i hereby certify that the attached invoice(s), or bill(s) is (are) true and I
correct and I have audited same in accordance with IC 5- 11- 10 -1.6
Date 6 ffic
VOUCHER 091869 WARRANT ALLOWED
"8000 7 Collections Center Dr. ca
IN SUM OF
F� 'CH CHEMICAL CO. CORP 4a'T�
2 0
=Chicago, IL 60693
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
16 6230908 01- 6180 -03 $562.39
Voucher Total $562.39
C�Ost distribution ledger classification if
claim paid under vehicle highway fund