HomeMy WebLinkAbout213198 09/25/2012 CITY OF CARMEL, INDIANA VENDOR: 00353237 Page 1 of 1
} ONE CIVIC SQUARE TESTAMERICA INC
€ r' CHECK AMOUNT: $75.60
CARMEL, INDIANA 46032 PD BOX 122314 DEPT 2314
>+ a� DALLAS TA 75312-2314 CHECK NUMBER: 213198
CHECK DATE: 9125/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
651 5023990 21030334 75 . 60 OTHER EXPENSES
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4738 Gateway Circle Dayton,OH 45440 800-572-9839 Fax:937-499-1249
Invoice Number: 21030334
Invoice To:
Remit Payment To:
Carmel VAVTP-Billing TestAmerica Laboratories,Inc.
Lisa Kempa Dept 2314
760 Third Avenue SW P.O.Box 122314
Carmel,IN 46032 Dallas,TX 75312-2314
1406871 TestAmericaEIN:23-2919996
For Billing Inquiries please contact; 800-572-9839
Client- Carmel WWTP Terms: See Below
Invoice Date: 06/29/12 Client Contact: David Dye
Lab Contact: Project: Distilled Water Analysis!Distilled Water Analysis
Taryn Man PO Number: Dave
taryn.mancine@testarnericaine.com Samples Received: 06/25/12 Samples Reported: 06/29/12
Workorder: DVF0992 Rush Rush Unit Extended
Qty Analysis/Description Matrix TAT Charge Cost Cost
I Cadmium Total EPA 200.7 Water-NonPotable NA None $12.00 $12.00
1 Chromium Total EPA 200.7 Water-NonPotable NA Neiie $12.00 $12.00
1 Copper Total EPA 200.7 Water-NonPotable NA None $12.00 $12.00
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 Zinc Total EPA 200.7 Water-NonPotable NA None $12.00 $12.00
Additional Items
I Environmental Management Fee 5.00% $3.60
Invoice Total: $75.60
Any applicable rush charges are based on the actual ttim-around-time met.
Prices shown include all applicable discounts..TestAmerica's Standard Terms&Conditions(Net 30 Days)apply to all Invoice: 21030334
work performed and invoiced unless superseded by a specific executed contract vehicle. Page 1 of I
VOUCHER # 125678 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
21030334 01-7352-05 $75.60
Voucher Total $75.60
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 9/18/2012
Invoice Invoice Description
Date . Number (or note attached invoice(s) or bill(s)) Amount
9/18/2012 21030334 $75.60
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