209369 05/22/2012 CITY OF CARMEL, INDIANA VENDOR: 00353237 Page 1 of 1
ONE CIVIC SQUARE TESTAMERICA INC CHECK AMOUNT: $119.70
CARMEL, INDIANA 46032 PO BOX 122314 DEPT 2314
DALLAS TX 75312 -2314 CHECK NUMBER: 209369
CHECK DATE: 5/22/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 21026665 119.70 CONT SVS- TESTING -S PL
T ORICIIV�L ®ICE
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4738 Qatcway Circle Dayton, OR 45440 800 -572 -9839 Fax;937- 499 -1249
Invoice Number: 21026665
Invoice To:
Remit Payment To:
Carmel WWTP TestAmerica Laboratories, Inc.
Teresa Lewis Dept 2314
9609 Hazel Dell Pkwy P.O. Box 122314
Indianapolis, IN 46280 Dallas, TX 75312-2314
TestAmerica EIN: 23- 2919996
1406871
For Billing Inquiries please contact: 800 572 -9839
Client: Carmel WWTP Terms: See Below
Invoice Date: 03/08/12 Client Contact: Teresa Lewis i
Lab Contact:
Taryn Mancine Project: Horton Fan Quarterly Analysis /Horton
taryn .mancine®testamericainc.com PO Number: TERESA
Samples Received: 02/29112 Samples Reported: 03/08/12
Workorder: DVB1100 Rush Rush Unit Extended
Qty Analysis/Description Matrix TAT Charge Cost Cost
1 Cadmium Total EPA 200.7 Water NonPotable NA None $12.00 $12.00
1 Chromium Total EPA 200.7 Water NonPotable NA None $12.00 $12.00
1 Copper Total EPA 200.7 Water NonPotable NA None $12.00 $12.00
1 Cyanide, EPA 335.4 Water- NonPotable NA None $30.00 $30.00
1 Lead Total EPA 200.7 Water NonPotable NA None $12.00 $12.00
1 Nickel Total EPA 200.7 Water NonPotable NA None $12.00 $12.00
1 Silver Total EPA 200.7 Water NonPotable NA None $12.00 $12.00
1 Zinc Total EPA 200.7 Water NonPotable NA None $12.00 $12.00
Additional Items
1 Environmental Management Fee 5.00% $5.70
Invoice Total: $119.70
Any applicable rash charges are based on the actual rum- around -time met.
Prices shown include all applicable discounts.TestAmerica's Standard Terms Conditions (Net 30 Days) apply to all Invoice: 21026665
work performed and invoiced unless superseded by a specific executed contract vehicle.
Page I of 1
VOUCHER 117324 WARRANT ALLOWED
00353237 IN SUM OF
TESTAMERICA INC
PO BOX 99742
Chicago, IL 60690
Carmel Wastewater Utility
ON ACCOUNT OF APPROPRIATION FOR
Board members
PO INV ACCT AMOUNT Audit Trail Code
21026665 01- 7352 -05 $119.70
Voucher Total $119.70
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
00353237
TESTAMERICA INC Purchase Order No.
PO BOX 99742 Terms
Chicago, IL 60690 Due Date 5/15/2012
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s)) Amount
5/15/2012 21026665 $119.70
hereby certify that the attached invoice(s), or bill(s) is (are) true and
;orrect and I have audited same in accordance with IC 5- 11- 10 -1.6
Date Officer