209960 06/20/2012 CITY OF CARMEL, INDIANA VENDOR: 00352978 Page 1 of 1
ONE CIVIC SQUARE CHEMSEARCH
CARMEL, INDIANA 46032 23261 NETWORK PLACE CHECK AMOUNT: $324.00
CHICAGO IL 60673 -1232 CHECK NUMBER: 209960
CHECK DATE: 6/20/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 745636 324.00 CONT SVS -OTHER
INVOICE Pa 1 of 1
Remittance Address
ORIGINAL COPY
CORRESPONDENCE. TO CHEMSEARCHFE
PO BOX 152170 REORDERS CALL 1- 800 -527 -9921
IRVINC'rx75015 23261 NETWORK PLACE
FAX 1 -972- 438 -0634 CHICAGO, IL 60673 -1232
W W W.CHEMSEARCHFE.COM
Sold To Slip To
Attn: PAUL ARNONE to Pay by EFT or
CITY OF CARMEL UTILITY Direct Debit, Email
760 3RD AVE SW STE 110 CITY OF CARMEL UTILITY
CARMEL IN 46032 901 N RANGELINE RD eac.credit @nch.com
CARMEL IN 46032
or call
1 -800 -527 -9919 X0541
Customer No. Billing Date 'Perms Due Date Ship Date Sales Order
229475 03- JUN -12 10 NET 13- JUN -12 764982
Invoice No." Purchase Order.No. Sales Rep. No. Sale§ Rep. Name
USFEF001 DUNSCOMB. Mr. JAMES L
Product Qty Ordered Description Packaging Qfy_Billed Unit Price 'Aniuunt
12021892 1 ECOFLOW BIOAMP PROGRAM EA 1.00 319.00 319.00
Merchandise State Tax Local Tax Split Inv. No. Currency Total Amount 1
319.00 0.00 0.00 5.00 USD 324.00
IN Tax ID 0003512371 -001 -3 Federal ID 75- 0457200
CHEMSE PCH FE, n1v_CION OF NCH.CORPORATION ALL RETURNS CLAIMS FOR ERRORS. OR \DJUS'IiYIENTS OP ANY KIND MUST BC MADE
Form Prescr ibe 301 -S St(e tRev. 1995) Accounts ACCOUNTS PAYABLE VOUCHER
Form 301 1995) C� ex) -3
J
TO Z A2 C
ADDRESS
Invoice Date Invoice Number Item Amount
I hereby certify that the attached invoice(s), or 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
1 19
Signature Title
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- 1 -1.6.
19 J (h Q-/%7
Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
SANITATION DEPARTMENT ACCT.
CARMEL, INDIANA NO.
Favor Of
C�iMSW-c14
Total Amount of Voucher
Deductions
4 S (v
o oa 1> o
Amount of Warrant
Month of 19
Acct.
VOUCHER RECORD No.
Collection System
Operation
Plant
Commercial
General
Undistributed
Construction
Depreciation Reserve
Stock Accounts Merchandise
Total
Allowed
Board Members
Filed
BOYCE FORMS SYSTEMS 1 -800- 382 -8702 325