178235 10/14/2009 CITY OF CARMEL, INDIANA VENDOR: 00350726 Page 1 of 1
ONE CIVIC SQUARE JONES CHEMICALS, INC
CHECK AMOUNT: $485.00
CARMEL, INDIANA 46032 PO BOX 412641
•4<ION .Q.
KANSAS CITY MO 64141 CHECK NUMBER: 178235
CHECK DATE: 10/14/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 W08731 446023 485.00 CHLORINE
WWW.jCiGhemicals.com INVOICE
Inv Date Invoice
***ORIGINAL***
Jones Chemicals Inc. JCI JONES CHEMICALS, INC.. 09125/2009 446023
BEECH GROVE BRANCH LOCATION Date Shipped OrderlBOL
600 BETHEL AVENUE
BEECH GROVE, IN 46107 09/25/2009 315210
Customer Number Phone' (317) 787 -8362
20142250 Fax: (317) 787-8384
email: cs @)cichem.com
r
S CARMEL UTILITIES (ND) S ID 1
0 ATTN: ACCTS PAYABLE H WATER TREATMENT PLANT #4
L 3450 W. 131 ST STREET
10675 N. GRAY ROAD
D Westfield, IN 46074 1 P CARMEL IN 46032-
0 Q USA 4 T USA
Customer PO FOB Remark Freight Terms Sales ID
ROB Destination Delivered SOUTH
Release Ship Via Terms Due Date Discount Due Date
JCI N30 1012512009 50125f2009
Units Package Product Name Total Quantity Unit Price Amount
1.00 2,000 lb CONTAINER CHLORINE 1.0000ITon 485.0000 [Ton 485.00
1001.004
CHLORINE (e)
General I Zemarks: EMAIL INVOI E TO: kloveall @carmei.in.gov
RET'D 1 MT CL2 FONS
NO DEPOSIT
FSC EXEMPT
PRICES SUBJECT TO CHANGE WITHOUT NOTICE
Total: 485.00
Remit To: JCI Jones Chemicals, Inc. PLEASE PAY
P.O. Box 412641 THIS AMOUNT
Kansas City, MO 64141- USA
Page 1 of 1
*JCI Welcomes payments by Visa, Amex, and EFT"
Prescribed by State Board of Accounts City Form No. 201 (Rev 1995)
ACCOUNTS PAYABLE VOUCHER t
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
350726
JONES CHEMICALS, INC Purchase Order No.
PO BOX 412641 Terms
KANSAS CITY, MO 64141 Due Date 10/5/2009
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
10/5/2009 446023 $485.00
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 O r
VOUCHER 093160 WARRANT ALLOWED
3`i0726 4p,A IN SUM OF
A)NES CHEMICALS, INC P
PO BOX 412641
KANSAS CITY, MO 64141 N -P
Carmel Water Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
(r�3 446023 01- 6180 -03 $485.00
I Voucher Total $485.00
Cost distribution ledger classification if
claim paid under vehicle highway fund