208330 04/25/2012 CITY OF CARMEL, INDIANA VENDOR: 00350569 Page 1 of 1
ONE CIVIC SQUARE HOOSIER MICROBIOLOGICAL LAB
a CARMEL, INDIANA 46032 912 W MCGALLIARD CHECK AMOUNT: $80.00
MUNCIE IN 47303 -1702 CHECK NUMBER: 208330
CHECK DATE: 4/25/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
211 4462838 lSS96 80.00 STORM WATER PHASE II
HML, Inc Invoice
912 W. McGalliard Rd
Date Invoice#
Muncie, IN 47303
765 -288 -1124 3/30/2012 15596
Bill To
Carmel Drinking Water Plant
Jaimie Foreman
5484 E. 126th St.
Carmel, IN 46033
P.O. No. Terms Due Date
Net 30 4/29/2012
Quantity Description Rate Amount
1 Iron Forming Bacteria (SM9240B) 80.00 80.00
SA #250175
DETACH AND RETURN LOWER PORTION WITH PAYMENT
HML, Inc Carmel Drinking Water Plant
912 W. McGalliard Rd Invoice Jaimie Foreman
Muncie, IN 47303 15596 5484 E. 126th St.
Carmel, IN 46033
PLEASE PAY THIS AMOUNT $80.00
HML, Inc Statement
912 W. McGalliard Rd
Date
Muncie, IN 47303
765- 288 -1124 4/2/2012
�c
e�
To:����
Carmel Drinking Water Plant
Jaimie Foreman v�
5484 E. 126th St.
Carmel, IN 46033
Amount Due A mou nt Enc..
$80.00
Date Transaction Amount Balance
03/30/2012 INV 15596. Due 04/29/2012. Orig. Amount $80.00. 80.00 80.00
i
i
1 -30 DAYS PAST 31 -60 DAYS PAST 61 -90 DAYS PAST OVER 90 DAYS
CURRENT Amount Due
DUE DUE DUE PAST DUE
80.00 0.00 0.00 0.00 0.00 $80.00
4
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
`N L J_ G Purchase Order No.
N I ��l�lX,� IV1 9d Terms
MU Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
12
Total ,OD
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.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF
q vV IVV W 6i oLd &P
lui V)C i K ,1 4I- M75
ON ACCOUNT OF APPROPRIATION FOR
2l l
Board Members
INVOICE NO. ACCT #!TITLE AMOUNT
DEPT I hereby certify that the attached invoice(s), or
��b q 3 bill(s) is (are) true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
20
ate
itle
Cost distribution ledger classification if
claim paid motor vehicle highway fund