207941 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 358238 Page 1 of 1
ONE CIVIC SQUARE LABCHEM INC
CARMEL, INDIANA 46032 200 WILLIAM PITT WAY CHECK AMOUNT: $206.84
PITTSBURGH PA 15238 CHECK NUMBER: 207941
CHECK DATE: 4/1012012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 791246 206.84 OTHER EXPENSES
INVOICE
LK LabChem Inc Invoice ID :791246
200 William Pitt Way Sales Order ID 796128
Pittsburgh, PA 15238 Invoice Date 327/2012
Phone: (412) 826 -5230 Ship Dam 3/27/2012 1:05:00 PM
Fax: (412) 826 -5234 Customer PO ID TERESA
Page Number I of I
AR Terms: Due Date: Amount Due:
Net 30 Days 4/26/2012 $206.84
Bill To: 1265 Ship'to
CARMEL WWTP CARMEL WWTP
ATTN: ACCOUNTS PAYABL 9609 HAZEL DELL PKWY
760 3RD AVE SOUTHWEST INDIANAPOLIS, IN 46280 -2935
SUITE 110 USA
CARMEL, IN 46032
USA
Order Date: 3/27/2012 11:25:05 AM FOB: Pittsburgh, PA
Packing Slip: 392242 Currency Type: USD
Ship Method: Fed Ex Gmund Service
Line Nbr Item ID/ Item Name Unit of Shipped Unit Price Sales Tax Extra Extended
Cast Item ID Measure Qry Charges Price
I LC148451 /GLUCOSE- GLUTAM IC AC ID EA 4.0000 531.5000 50.0000 S126.00
13/0 Qh' 0.0000
Lot Number Expiration Date [.at 'Frans Oh'
6051 -19 03/05/2014 4
Line Item Total $126.00
2 I.C226002 SILVER NI "f RATE. 0.0141N (0.0141 M) EA 2.0000 534.6000 S0.0000 S69.20
B/O Qty: 0.0000
[.at Number Expiration Date Lot Trans Oh'
13009 -13 07/102013 2
Line Item Total: $6910
Subtotal: 5195.20
Sales Tax: $0.00
Tracking Numbers:
Shipping Charges: 511.64
X015396465191141 ,015396465191158 Total: 5206.84
From #34.01 04/11/2011 See 'www.labchem.nel" Jo,C of A and MSDS infonnation All Products Made In USA
VOUCHER 117098 WARRANT ALLOWED
358238 IN SUM OF
LABCHEM INC
200 WILLIAM PITT WAY
PITTSBURGH, PA 15238
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
791246 01-7202 -05 $206.84
Voucher Total $206.84
Cost distribution ledger classification if
claim paid under vehicle highway fund
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
358238
LABCHEM INC Purchase Order No.
200 WILLIAM PITT WAY Terms
PITTSBURGH, PA 15238 Due Date 4/4/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
4/412012 791246 $206.84
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