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211399 07/31/2012 CITY OF CARMEL, INDIANA VENDOR: 355130 Page 1 of 1 ONE CIVIC SQUARE NORTH CENTRAL LABORATORIES € CHECK AMOUNT: $150.44 CARMEL, INDIANA 46032 P O BOX 8 BIRNAMWOOD WI 54414 CHECK NUMBER: 211399 CHECK DATE: 7131/2012 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 651 5023990 306958 150 . 44 OTHER EXPENSES North Cehiral LABS .. FEDID:39-1538387 Lab Supplies since 1985 1-800-648-7836 Fax: .ncla s.com 449-2454 www.nclabs.com Email:nclabs@nclabs.com UJ VJ INVOICE NO. INVOICE DATE S CITY OF CARMEL 07/11/2012 O 9609 HAZEL DELL PARKWAY YOUR ACCOUNT NO. L 7804 D INDIANAPOLIS, IN 46280 YOUR ORDER NO. T O SHIPPE 11pq 07.110/2012 SHIPPED TO _ DELL PARKWAY INDIANAPOLIS IN 46280 t..:'o" b " "Y_.•':'..4s' _ ..Y'i4n'. it.:i "�:fiP. ♦ .' - �' ♦ • 1 500 g N-50, Nitrification Inhibitor 140.00 140.00 Delivery Charges 10.44 SUB-TOTAL 150.44 WI Sales Tax-Exempt .00 TOTAL 150.44 Thank you for your order! ! tiI' i PLEASE PAY FROM THIS INVOICE WITHIN 30 DAYS REMIT TO: NCL of Wisconsin, Inc. P.O. Box 8, Birnamwood,WI 54414 VOUCHER # 125359 WARRANT # ALLOWED 355130 IN SUM OF $ NORTH CENTRAL LABORATORIES PO BOX 8 BIRNAMWOOD, WI 54414 Carmel Wastewater Utility ON ACCOUNT OF APPROPRIATION FOR Board members PO# INV# ACCT# AMOUNT Audit Trail Code 306958 01-7202-05 $150.44 Voucher Total $150.44 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 355130 NORTH CENTRAL LABORATORIES Purchase Order No. P O BOX 8 Terms BIRNAMWOOD, WI 54414 Due Date 7/23/2012 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) Amount 7/23/2012 306958 $150.44 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 7 A 7 Date Officer